Characterizing physician EHR use with vendor derived data: a feasibility study and cross-sectional analysis. (4th May 2021)

• Record Type: Journal Article
• Authors: Melnick, Edward R; Ong, Shawn Y; Fong, Allan; Socrates, Vimig; Ratwani, Raj M; Nath, Bidisha; Simonov, Michael; Salgia, Anup; Williams, Brian; Marchalik, Daniel; Goldstein, Richard; Sinsky, Christine A
• Is Part Of: Journal of the American Medical Informatics Association. Volume 28:Number 7(2021)
• Page Start: 1383
• Page End: 1392
• Publication Date: 2021-05-04
• Subjects: Medical informatics -- Periodicals; Information Services -- Periodicals; Medical Informatics -- Periodicals; Médecine -- Informatique -- Périodiques; Informatica; Geneeskunde; Informatique médicale; Computer network resources; Electronic journals; 610.285
• DOI: 10.1093/jamia/ocab011
• Languages: English
• ISSNs: 1067-5027

Abstract

Abstract: 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. 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. 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. 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.