Oliver T Nguyen1,2, Kea Turner3,4, Nate C Apathy5, Tanja Magoc6, Karim Hanna7, Lisa J Merlo8, Christopher A Harle6,9, Lindsay A Thompson9,10, Eta S Berner1, Sue S Feldman1. 1. Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama, USA. 2. Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida, USA. 3. Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA. 4. Department of Oncological Sciences, University of South Florida, Tampa, Florida, USA. 5. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 6. Clinical and Translational Science Institute, University of Florida, Gainesville, Florida, USA. 7. Department of Family Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA. 8. Department of Psychiatry, University of Florida, Gainesville, Florida, USA. 9. Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA. 10. Department of Pediatrics, University of Florida, Gainesville, Florida, USA.
Abstract
OBJECTIVE: This study aimed to understand the association between primary care physician (PCP) proficiency with the electronic health record (EHR) system and time spent interacting with the EHR. MATERIALS AND METHODS: We examined the use of EHR proficiency tools among PCPs at one large academic health system using EHR-derived measures of clinician EHR proficiency and efficiency. Our main predictors were the use of EHR proficiency tools and our outcomes focused on 4 measures assessing time spent in the EHR: (1) total time spent interacting with the EHR, (2) time spent outside scheduled clinical hours, (3) time spent documenting, and (4) time spent on inbox management. We conducted multivariable quantile regression models with fixed effects for physician-level factors and time in order to identify factors that were independently associated with time spent in the EHR. RESULTS: Across 441 primary care physicians, we found mixed associations between certain EHR proficiency behaviors and time spent in the EHR. Across EHR activities studied, QuickActions, SmartPhrases, and documentation length were positively associated with increased time spent in the EHR. Models also showed a greater amount of help from team members in note writing was associated with less time spent in the EHR and documenting. DISCUSSION: Examining the prevalence of EHR proficiency behaviors may suggest targeted areas for initial and ongoing EHR training. Although documentation behaviors are key areas for training, team-based models for documentation and inbox management require further study. CONCLUSIONS: A nuanced association exists between physician EHR proficiency and time spent in the EHR.
OBJECTIVE: This study aimed to understand the association between primary care physician (PCP) proficiency with the electronic health record (EHR) system and time spent interacting with the EHR. MATERIALS AND METHODS: We examined the use of EHR proficiency tools among PCPs at one large academic health system using EHR-derived measures of clinician EHR proficiency and efficiency. Our main predictors were the use of EHR proficiency tools and our outcomes focused on 4 measures assessing time spent in the EHR: (1) total time spent interacting with the EHR, (2) time spent outside scheduled clinical hours, (3) time spent documenting, and (4) time spent on inbox management. We conducted multivariable quantile regression models with fixed effects for physician-level factors and time in order to identify factors that were independently associated with time spent in the EHR. RESULTS: Across 441 primary care physicians, we found mixed associations between certain EHR proficiency behaviors and time spent in the EHR. Across EHR activities studied, QuickActions, SmartPhrases, and documentation length were positively associated with increased time spent in the EHR. Models also showed a greater amount of help from team members in note writing was associated with less time spent in the EHR and documenting. DISCUSSION: Examining the prevalence of EHR proficiency behaviors may suggest targeted areas for initial and ongoing EHR training. Although documentation behaviors are key areas for training, team-based models for documentation and inbox management require further study. CONCLUSIONS: A nuanced association exists between physician EHR proficiency and time spent in the EHR.
Authors: P M Neri; L A Volk; S Samaha; S E Pollard; D H Williams; J M Fiskio; E Burdick; S T Edwards; H Ramelson; G D Schiff; D W Bates Journal: Appl Clin Inform Date: 2014-05-14 Impact factor: 2.342
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