Dissecting the pre-handoff chart biopsy: Information seeking in the electronic health record

Pre-handoff "chart biopsy" involves the brief reviewing by a clinician of a patient's record prior to accepting responsibility for the care of that patient. It is an information seeking activity enabled by electronic health records. This paper reports on a qualitative study of chart biopsies conducted by General Medicine physicians in a large quaternary teaching hospital prior to discussing possible admissions of patients from the Emergency Department (ED). The paper makes three contributions. First, this research provides an account of an information practice not previously documented and characterizes that practice as a social constructionist activity. Second, the study demonstrates that new information technologies can enable new information practices which in turn can alter the balance of participation in organizational coordination efforts. Third, the study shows that the understandings constructed from information seeking can have consequences for organizational orders.