Effect of restricting electronic health records on clinician efficiency: substudy of a randomized clinical trial. (3rd April 2023)

• Record Type: Journal Article
• Authors: Kneifati-Hayek, Jerard Z; Applebaum, Jo R; Schechter, Clyde B; Dal Col, Alexis; Salmasian, Hojjat; Southern, William N; Adelman, Jason S
• Is Part Of: Journal of the American Medical Informatics Association. Volume 30:Number 5(2023)
• Page Start: 953
• Page End: 957
• Publication Date: 2023-04-03
• Subjects: electronic health record -- efficiency -- audit log data; 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/ocad025
• Languages: English
• ISSNs: 1067-5027

Abstract

Abstract: A prior randomized controlled trial (RCT) showed no significant difference in wrong-patient errors between clinicians assigned to a restricted electronic health record (EHR) configuration (limiting to 1 record open at a time) versus an unrestricted EHR configuration (allowing up to 4 records open concurrently). However, it is unknown whether an unrestricted EHR configuration is more efficient. This substudy of the RCT compared clinician efficiency between EHR configurations using objective measures. All clinicians who logged onto the EHR during the substudy period were included. The primary outcome measure of efficiency was total active minutes per day. Counts were extracted from audit log data, and mixed-effects negative binomial regression was performed to determine differences between randomized groups. Incidence rate ratios (IRRs) were calculated with 95% confidence intervals (CIs). Among a total of 2556 clinicians, there was no significant difference between unrestricted and restricted groups in total active minutes per day (115.1 vs 113.3 min, respectively; IRR, 0.99; 95% CI, 0.93–1.06), overall or by clinician type and practice area.