A Practical Framework for Identifying Documentation Fragmentation Risk in Outpatient Care

This report presents a structured framework for identifying documentation fragmentation risk in outpatient care. Documentation fragmentation refers to the separation of clinically relevant patient information across sources, systems, or encounters in a manner that impairs timely diagnostic synthesis. The framework delineates five domains of fragmentation: Source, Temporal, Responsibility, Interface, and Cognitive. It describes associated failure modes that may contribute to delayed diagnosis. The objective of this work is to support prospective risk assessment, quality improvement initiatives, and future research focused on diagnostic safety in ambulatory settings.