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北美 10210 名胃肠病学家的电子病历临床工作量指标。

Electronic medical record clinical workload metrics from 10,210 gastroenterologists in North America.

机构信息

University of California San Diego School of Medicine, La Jolla, California, USA.

Rady Children's Hospital, San Diego, California, USA.

出版信息

J Pediatr Gastroenterol Nutr. 2024 Sep;79(3):558-563. doi: 10.1002/jpn3.12313. Epub 2024 Jul 21.

Abstract

In the United States, clinical work had been primarily compensated via a relative value unit (RVU) system reliant on professional surveys estimating the value of clinical care events. However, with the advent of time-based billing in 2021, time accounting has become an important work compensation metric. The Signal functionality within Epic, the most widely used electronic medical record (EMR) system in North America, tracks clinician time within the system. We extracted Epic Signal data from 10,200 gastroenterologists at 356 North American institutions for analysis. Workload metrics were reported as group median (interquartile range) per month and comparisons were performed using nonparametric testing. Gastroenterologists exhibit different EMR time patterns based on clientele and practice arenas. Compared with counterparts, pediatric and academic gastroenterologists spend more time at each encounter which had not been compensated under prior RVU valuations. Clinical compensation benchmarks should be driven by time-based workload metrics to ensure appropriate compensation.

摘要

在美国,临床工作的主要报酬是通过相对价值单位(RVU)系统来支付的,该系统依赖于专业调查来估算临床护理事件的价值。然而,随着 2021 年基于时间的计费的出现,时间核算已成为重要的工作报酬指标。Epic 中的 Signal 功能是北美使用最广泛的电子病历(EMR)系统,它可以跟踪临床医生在系统中的工作时间。我们从北美 356 家机构的 10200 名胃肠病学家中提取了 Epic Signal 数据进行分析。工作量指标以每月的组中位数(四分位距)报告,使用非参数检验进行比较。根据患者群体和实践领域的不同,胃肠病学家的 EMR 时间模式也不同。与同行相比,儿科和学术性胃肠病学家在每次就诊时花费的时间更多,而这些时间在之前的 RVU 估值中并未得到报酬。临床补偿基准应该由基于时间的工作量指标来驱动,以确保适当的补偿。

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