In recent years, studies in health and medicine have shifted toward eHealth communication and the relationships among human interaction, computer literacy, and digital text content in medical discourses (1-6). Clinicians, however, continue to struggle with EHR usability, including how to effectively capture patient data without error (7-9). Usability is especially problematic for clinicians, who must now acquire new skills in electronic documentation (10). Challenges with the EHR occur because of clinicians' struggle with attention to the non-linear format of clinical content and automated technologies (11). It is therefore important to understand how attention structures are visually situated within the EHR's narrative architecture and audience for whom electronic text is written. It is equally important to visualize and track how automated language and design in health information technology (HIT) affect users' attention when documenting clinical narratives (12). In the study of health information technology, researchers of eHealth platforms need to recognize how the construction of human communication lies within the metaphoric expression, design, and delivery of the EHR's information architecture (13). Many studies of electronic health records (EHR) examine the design and usability in the development stages. Some studies focus on the economic value of the EHR Medicare incentive program, which affects providers' return on investment (ROI). Few studies, however, identify the communicative value of how attention structures within the EHR's information architecture compete for users' attention during the clinical documentation process (9, 14).
Objective: To track and visually assess how automated attention structures within the electronic health record (EHR) compete for clinicians attention during computer physician order entry that could potentially lead to transactions hazards in the clinical narrative.