Department of Medicine, American Medical Association, Chicago, Illinois, USA.
Department of Medical Informatics and Clinical Epidemiology, Oregon Health Sciences University, Oregon, USA.
J Am Med Inform Assoc. 2020 Apr 1;27(4):639-643. doi: 10.1093/jamia/ocz223.
Electronic health record (EHR) log data have shown promise in measuring physician time spent on clinical activities, contributing to deeper understanding and further optimization of the clinical environment. In this article, we propose 7 core measures of EHR use that reflect multiple dimensions of practice efficiency: total EHR time, work outside of work, time on documentation, time on prescriptions, inbox time, teamwork for orders, and an aspirational measure for the amount of undivided attention patients receive from their physicians during an encounter, undivided attention. We also illustrate sample use cases for these measures for multiple stakeholders. Finally, standardization of EHR log data measure specifications, as outlined here, will foster cross-study synthesis and comparative research.
电子健康记录 (EHR) 日志数据在衡量医生用于临床活动的时间方面显示出了潜力,有助于更深入地了解和进一步优化临床环境。在本文中,我们提出了 7 项 EHR 使用的核心衡量标准,这些标准反映了实践效率的多个维度:EHR 总用时、工作时间之外的时间、文档记录时间、开处方时间、收件箱时间、医嘱协作时间,以及一个理想的衡量标准,即患者在就诊期间从医生那里获得的非分散注意力的时间,即非分散注意力时间。我们还为多个利益相关者展示了这些衡量标准的示例使用案例。最后,如本文所述,EHR 日志数据衡量标准的标准化将促进跨研究的综合和比较研究。