Characterizing physician EHR use with vendor derived data: a feasibility study and cross-sectional analysis.

MedStar author(s):
Citation: Journal of the American Medical Informatics Association. 28(7):1383-1392, 2021 07 14.PMID: 33822970Institution: MedStar Institute for Innovation | MedStar Washington Hospital CenterDepartment: National Center for Human Factors in Healthcare | Urology; Literature and MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Medicine | *Physicians | Child | Cross-Sectional Studies | Electronic Health Records | Feasibility Studies | Female | HumansYear: 2021ISSN:
  • 1067-5027
Name of journal: Journal of the American Medical Informatics Association : JAMIAAbstract: CONCLUSIONS: For every 8 hours of scheduled patient time, ambulatory physicians spend more than 5 hours on the EHR. Physician gender, specialty, and number of clinical hours practicing are associated with differences in EHR time. While audit logs remain a powerful tool for understanding physician EHR use, additional transparency, granularity, and standardization of vendor-derived EHR use data definitions are still necessary to standardize EHR use measurement. Copyright (c) The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association.MATERIALS AND METHODS: A cross-sectional analysis of ambulatory physicians EHR use across the Yale-New Haven and MedStar Health systems was performed for August 2019 using 7 proposed core EHR use metrics normalized to 8 hours of patient scheduled time.OBJECTIVE: To derive 7 proposed core electronic health record (EHR) use metrics across 2 healthcare systems with different EHR vendor product installations and examine factors associated with EHR time.RESULTS: Five out of 7 proposed metrics could be measured in a population of nonteaching, exclusively ambulatory physicians. Among 573 physicians (Yale-New Haven N = 290, MedStar N = 283) in the analysis, median EHR-Time8 was 5.23 hours. Gender, additional clinical hours scheduled, and certain medical specialties were associated with EHR-Time8 after adjusting for age and health system on multivariable analysis. For every 8 hours of scheduled patient time, the model predicted these differences in EHR time (P < .001, unless otherwise indicated): female physicians +0.58 hours; each additional clinical hour scheduled per month -0.01 hours; practicing cardiology -1.30 hours; medical subspecialties -0.89 hours (except gastroenterology, P = .002); neurology/psychiatry -2.60 hours; obstetrics/gynecology -1.88 hours; pediatrics -1.05 hours (P = .001); sports/physical medicine and rehabilitation -3.25 hours; and surgical specialties -3.65 hours.All authors: Fong A, Goldstein R, Marchalik D, Melnick ER, Nath B, Ong SY, Ratwani RM, Salgia A, Simonov M, Sinsky CA, Socrates V, Williams BOriginally published: Journal of the American Medical Informatics Association. 2021 Apr 05Fiscal year: FY2021Fiscal year of original publication: FY2021Digital Object Identifier: Date added to catalog: 2021-06-07
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Journal Article MedStar Authors Catalog Article 33822970 Available 33822970

CONCLUSIONS: For every 8 hours of scheduled patient time, ambulatory physicians spend more than 5 hours on the EHR. Physician gender, specialty, and number of clinical hours practicing are associated with differences in EHR time. While audit logs remain a powerful tool for understanding physician EHR use, additional transparency, granularity, and standardization of vendor-derived EHR use data definitions are still necessary to standardize EHR use measurement. Copyright (c) The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association.

MATERIALS AND METHODS: A cross-sectional analysis of ambulatory physicians EHR use across the Yale-New Haven and MedStar Health systems was performed for August 2019 using 7 proposed core EHR use metrics normalized to 8 hours of patient scheduled time.

OBJECTIVE: To derive 7 proposed core electronic health record (EHR) use metrics across 2 healthcare systems with different EHR vendor product installations and examine factors associated with EHR time.

RESULTS: Five out of 7 proposed metrics could be measured in a population of nonteaching, exclusively ambulatory physicians. Among 573 physicians (Yale-New Haven N = 290, MedStar N = 283) in the analysis, median EHR-Time8 was 5.23 hours. Gender, additional clinical hours scheduled, and certain medical specialties were associated with EHR-Time8 after adjusting for age and health system on multivariable analysis. For every 8 hours of scheduled patient time, the model predicted these differences in EHR time (P < .001, unless otherwise indicated): female physicians +0.58 hours; each additional clinical hour scheduled per month -0.01 hours; practicing cardiology -1.30 hours; medical subspecialties -0.89 hours (except gastroenterology, P = .002); neurology/psychiatry -2.60 hours; obstetrics/gynecology -1.88 hours; pediatrics -1.05 hours (P = .001); sports/physical medicine and rehabilitation -3.25 hours; and surgical specialties -3.65 hours.

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