Enhancing Workflow Recall in Electronic Health Records Using Mouse Indicators: A Randomized Parallel Pilot Study

Background Electronic health records (EHRs) are databases that collect, store, and exchange patient health information. Although 95% of United States (U.S.) hospitals use EHRs, staff often struggle to navigate them, causing delayed services, frustration, and patient risk. This parallel randomized pilot study tested whether an educational tool, the mouse indicator (MI), improves clinicians' memory of how to navigate EHRs, with the alternative hypothesis that it would enhance recall. Methods This study took place remotely, June to November 2024. Participants were U.S.-based adult healthcare workers with access to a computer, audio, video, and a stable internet connection. Exclusion criteria included photosensitivity. Advertisement was through the online recruitment platform Prolific. Eligible participants attended one-on-one, proctored sessions where they were randomly assigned with a 1:1 allocation between the control and intervention groups using a remote web service. There was no blinding. Participants viewed two demonstrations of how to click nine sequential buttons, then tried to replicate the workflow. Intervention group demonstrations used the MI. The number of correct clicks (zero to nine) measured recall. The objectives were to assess feasibility, and to determine if the MI improved workflow recall. A one-tailed independent samples t test was used to compare between-group means. Results Over four weeks, 301 individuals showed interest; following screening, 48 met inclusion criteria and were selected, randomized, and equally distributed between the control and intervention groups. This met a priori recruiting and retention criteria for feasibility. Their data were then analyzed. While the intervention group had higher recall ( M = 7.5, SD = 2.5) than the control group ( M = 6.7, SD = 3), the difference was not statistically significant ( p = .174, d = .27, 95% CI [-0.84, 2.34]). An exploratory ANCOVA revealed that participant age significantly influenced results, and age-corrected outcomes became significant ( p = .032). There were no adverse events. Conclusions The pilot study was feasible. Results were inconclusive. The age-corrected analysis suggests the MI may improve workflow recall, warranting a full-scale, age-balanced study to assess the true effect. Trial Registration Not applicable.