Khairat Saif, Zalla Lauren, Gartland Allie, Seashore Carl
Carolina Health Informatics Association, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Cecil G. Sheps Center for HEalth Service Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Front Digit Health. 2021 Sep 6;3:689646. doi: 10.3389/fdgth.2021.689646. eCollection 2021.
The purpose of this study was to evaluate the variations in electronic health record (EHR) activity among General and Specialty pediatricians by investigating the time spent and documentation length, normalized for workload. We conducted a cross-sectional study of pediatric physicians using Epic EHR at a major Southeastern academic healthcare system. We collected user-level EHR activity data of 104 pediatric physicians over 91 days from April 1 to June 30, 2020. Of the 104 pediatrics physicians, 56 (54%) were General pediatricians and 48 (46%) were Specialists pediatricians. General pediatricians spent an average of 17.6 min [interquartile range (IQR): 12.9-37] using the EHR per appointment, while Specialists spent 35.7 min (IQR: 28-48.4) per appointment. Significant negative associations were found between proficiency scores and the amount of time spent in the system for Generalists ( < 0.001). On the contrary, significant positive associations were found between proficiency scores and the amount of time spent in the system for Specialists ( < 0.01). We report an association between EHR proficiency and efficiency levels among pediatricians within the same healthcare system, receiving the same EHR training, and using the same EHR system. The profound differences in EHR activity suggest that higher priority should be given to redesigning EHR training methods to accommodate the learning needs of physicians.
本研究的目的是通过调查按工作量标准化后的电子健康记录(EHR)活动时间和文档长度,评估普通儿科医生和专科儿科医生在EHR活动方面的差异。我们在东南部一个主要的学术医疗系统中对使用Epic EHR的儿科医生进行了一项横断面研究。我们收集了2020年4月1日至6月30日期间104名儿科医生91天的用户级EHR活动数据。在这104名儿科医生中,56名(54%)是普通儿科医生,48名(46%)是专科儿科医生。普通儿科医生每次预约使用EHR的平均时间为17.6分钟[四分位间距(IQR):12.9 - 37],而专科医生每次预约花费35.7分钟(IQR:28 - 48.4)。对于普通医生,熟练度得分与在系统中花费的时间量之间存在显著的负相关(<0.001)。相反,对于专科医生,熟练度得分与在系统中花费的时间量之间存在显著的正相关(<0.01)。我们报告了在同一医疗系统中、接受相同EHR培训并使用相同EHR系统的儿科医生中,EHR熟练度与效率水平之间的关联。EHR活动的巨大差异表明,应更优先重新设计EHR培训方法,以满足医生的学习需求。