Humanistic Charting: Empowering Person-centered Emergency Care Through Reimagining the Electronic Health Record
Department of Emergency Medicine, University of California, San Francisco (with UCLA and the University of Pennsylvania Health System)
How they used Delve
Emergency medicine researchers at UCSF used Delve to apply a two-author codebook to interviews with six emergency clinicians, drawing out themes and quotations on how a patient-completed narrative tool changed encounters in the emergency department.
“Qualitative analysis: Thematic analysis was conducted using a codebook developed by 2 authors (CM and ER/NG), who coded clinician interviews on Delve software, identifying emergent themes and relevant quotations.”
- Field
- Emergency medicine and health informatics; person-centered care and the electronic health record
- Data
- Pre- and post-use interviews with 6 emergency clinicians at the UCSF Parnassus Emergency Department, alongside surveys from those clinicians and 29 adult patients who completed the Humanistic Charting Tool between February and April 2023
- Approach
- Codebook-based thematic analysis of clinician interviews by two authors, identifying emergent themes and quotations; the authors note formal saturation could not be reached with six interviews and report only themes consistent across them. Survey data were analysed separately with two-sided paired t tests and Net Promoter Scores
- Data types
- Interviews, Open-ended survey responses
Abstract
Objectives: The rise in health care standardization has increased the focus on documentation, subsequently leading to the depersonalization of patient care. Humanistic Charting attempts to enhance person-centered care (PCC) by streamlining the integration of a patient’s narrative into the electronic health record (EHR), while reducing a clinician’s administrative workload. The Humanistic Charting Tool (HCT) transitions the collection and documentation of person-centric data to patients, empowering them to convey their values, preferences, and individuality. Methods: We carried out a pilot study in an academic emergency department (ED) at the University of California, San Francisco, between February and April 2023, involving 6 clinicians and 29 adult patients using the HCT. Clinicians reviewed HCT entries prior to patient encounters. The feasibility and impact of HCT were assessed using surveys and interviews pre- and postuse. The statistical significance of patient and clinician responses was assessed with 2-sided paired t tests. Results: The HCT was met with high patient satisfaction, with notable improvements in patient-rated care experience metrics post-HCT implementation, such as respect for patient preferences and clinician availability. The HCT received excellent Net Promoter Scores from both patients (52) and clinicians (83). Clinicians observed that the HCT promoted a humanistic care approach and helped alleviate burnout. Conclusions: In this pilot study, the HCT has demonstrated encouraging feasibility and promise in helping enhance PCC within the challenging ED environment. Clinicians have noted its advantages in providing deeper insights into patient histories and improving the quality of interactions, having the potential to aid in counteracting biases. This pilot study demonstrates the HCT’s potential to help foster humanism and PCC in emergency settings and supports the potential for broader applicability in health care systems.
Citation
Christopher Montgomery, Namrata Garg, Natasha Gonzalez, Elizabeth Raby, Susan Landon, Christopher Peabody, Nicholas Stark (2025). Humanistic Charting: Empowering Person-centered Emergency Care Through Reimagining the Electronic Health Record. Journal of the American College of Emergency Physicians Open. https://doi.org/10.1016/j.acepjo.2025.100084