Maloney Sean R, Peterson Sabrina, Kao Angela M, Sherrill William C, Green John M, Sachdev Gaurav
Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina.
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
J Surg Educ. 2020 Sep-Oct;77(5):1056-1062. doi: 10.1016/j.jsurg.2020.03.008. Epub 2020 Apr 16.
Time spent on the Electronic Health Record (EHR) influences surgical residents' clinical availability. Objective data assessing EHR usage among surgical residents are lacking and necessary.
DESIGN/PARTICIPANTS: Active EHR usage data for 70 surgical residents were collected from April 2015 through April 2016. Active EHR usage was defined as more than 15 keystrokes, or 3 mouse clicks, or 1700 "mouse miles" per minute. Usage data of different specialties, interns (PGY 1), juniors (PGY 2, 3), and seniors (PGY 4, 5) were compared.
Carolinas Medical Center, Charlotte, NC.
Interns spent more time than juniors on total EHR activities per day (134.5 vs 105.5 minutes, p < 0.001) and juniors spent more time per day than seniors (105.5 vs 78.7 minutes, p < 0.001). Among different EHR activities per patient, interns spent greater time than juniors on chart review (8.1 vs 6.2 minutes, p < 0.001), documentation (9.0 vs 6.5 minutes, p < 0.001), and orders (3.6 vs 3.0 minutes, p < 0.001). Juniors spent the same time as seniors on chart review (6.2 vs 6.5 minutes, p = 0.2). Juniors spent more time than seniors on documentation (6.5 vs 5.2 minutes, p < 0.001) and orders (3.0 vs 2.7 minutes, p < 0.05). Comparing EHR activities per patient among different specialties, General Surgery residents spent more time than Orthopedic residents on total EHR time (19.9 vs 15.9 minutes, p < 0.001), chart review (6.8 vs 5.7 minutes, p < 0.001), documentation (6.3 vs 5.6 minutes, p < 0.001), and orders (3.6 vs 2.6 minutes, p < 0.001). General Surgery residents spent less time than OB/GYN residents on total EHR time (19.9 vs 22 minutes, p < 0.01), chart review (6.8 vs. 7.5 minutes, p < 0.05), and documentation (6.3 vs 7.6 minutes, p < 0.001), but more time on orders (3.6 vs 2.9 minutes, p < 0.001).
These are the first reported objective findings on surgical resident use of the EHR and may provide an opportunity for improvement in EHR training and usage.
花在电子健康记录（EHR）上的时间会影响外科住院医师的临床可利用时间。目前缺乏且需要评估外科住院医师EHR使用情况的客观数据。
设计/参与者：收集了2015年4月至2016年4月期间70名外科住院医师的EHR实际使用数据。EHR实际使用被定义为每分钟超过15次击键、或3次鼠标点击、或1700“鼠标移动距离”。比较了不同专业、实习医生（PGY 1）、低年资住院医师（PGY 2、3）和高年资住院医师（PGY 4、5）的使用数据。
北卡罗来纳州夏洛特市卡罗莱纳医疗中心。
实习医生每天在EHR总活动上花费的时间比低年资住院医师多（134.5分钟对105.5分钟，p<0.001），低年资住院医师每天花费的时间比高年资住院医师多（105.5分钟对78.7分钟，p<0.001）。在每位患者的不同EHR活动中，实习医生在病历审查（8.1分钟对6.2分钟，p<0.001）、记录（9.0分钟对6.5分钟，p<0.001）和医嘱下达（3.6分钟对3.0分钟，p<0.001）上花费的时间比低年资住院医师多。低年资住院医师和高年资住院医师在病历审查上花费的时间相同（6.2分钟对6.5分钟，p = 0.2）。低年资住院医师在记录（6.5分钟对5.2分钟，p<0.001）和医嘱下达（3.0分钟对2.7分钟，p<0.05）上花费的时间比高年资住院医师多。比较不同专业每位患者的EHR活动，普通外科住院医师在EHR总时间（19.9分钟对15.9分钟，p<0.001）、病历审查（6.8分钟对5.7分钟，p<0.001）、记录（6.3分钟对5.6分钟，p<0.001）和医嘱下达（3.6分钟对2.6分钟，p<0.
