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使用K均值聚类分析医师篮筐负担与效率

Analyzing Physician In Basket Burden and Efficiency Using K-Means Clustering.

作者信息

Lattanze Vincent, Lan Xinyue, Vander Leest Drew, Sim Jasper, Fazzari Melissa, Xie Xianhong, Jariwala Sunit P

机构信息

Albert Einstein College of Medicine, Bronx, New York, United States.

Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States.

出版信息

Appl Clin Inform. 2025 May;16(3):640-651. doi: 10.1055/a-2562-1100. Epub 2025 Mar 19.

Abstract

Electronic health record (EHR) systems are essential for modern healthcare but contribute to a significant documentation burden, affecting physician workflow and well-being. While previous studies have identified differences in EHR usage across demographics, systematic methods for identifying high-burden physician groups remain limited. This study applies cluster analysis to uncover distinct EHR usage profiles and provide a framework to inform the development of targeted interventions.This study investigated two research questions: (1) Can cluster analysis effectively identify distinct physician EHR usage profiles? (2) How do these profiles vary across physician demographics and practice characteristics? We hypothesized that (1) EHR usage clusters would emerge based on workload intensity, after-hours documentation, and In Basket management patterns, and (2) would be significantly associated with physician experience, sex, and specialty.We analyzed outpatient EHR usage data from 323 physicians at an academic health system using Epic Signal, an analytical tool for Epic EHR. Using k-means clustering, we examined six metrics representing EHR workload (after-hours and extended-day activities) and In Basket efficiency (message handling and management patterns). We assessed cluster differences and conducted subgroup analyses by physician sex and specialty.Two distinct physician clusters emerged: one high-burden cluster, predominantly comprising experienced primary care physicians, and another lower-burden cluster, consisting mostly of younger specialists. Physicians in the high-burden cluster spent nearly three times as much time on after-hours documentation and In Basket management. While message response times remained similar, subgroup analyses revealed significant sex and specialty-based differences, particularly in the lower-burden cluster.Cluster analysis effectively identified distinct EHR usage patterns, highlighting disparities in workload by experience, sex, and specialty. This approach provides a scalable, data-driven method for health systems to identify at-risk groups and design targeted interventions to mitigate documentation burden and enhance EHR efficiency.

摘要

电子健康记录(EHR)系统对现代医疗保健至关重要,但会带来巨大的文档负担,影响医生的工作流程和幸福感。虽然先前的研究已经确定了不同人群在EHR使用方面的差异,但识别高负担医生群体的系统方法仍然有限。本研究应用聚类分析来揭示不同的EHR使用概况,并提供一个框架,为制定有针对性的干预措施提供参考。本研究调查了两个研究问题:(1)聚类分析能否有效地识别不同的医生EHR使用概况?(2)这些概况在医生的人口统计学特征和执业特点方面如何变化?我们假设:(1)基于工作量强度、下班后文档记录和收件篮管理模式会出现EHR使用聚类,(2)这些聚类与医生的经验、性别和专业显著相关。我们使用Epic Signal(一种用于Epic EHR的分析工具)分析了一家学术医疗系统中323名医生的门诊EHR使用数据。使用k均值聚类,我们检查了六个指标,这些指标代表EHR工作量(下班后和延长日活动)和收件篮效率(消息处理和管理模式)。我们评估了聚类差异,并按医生性别和专业进行了亚组分析。出现了两个不同的医生聚类:一个是高负担聚类,主要由经验丰富的初级保健医生组成;另一个是低负担聚类,主要由年轻的专科医生组成。高负担聚类中的医生在下班后文档记录和收件篮管理上花费的时间几乎是低负担聚类医生的三倍。虽然消息响应时间保持相似,但亚组分析显示了基于性别和专业的显著差异,特别是在低负担聚类中。聚类分析有效地识别了不同的EHR使用模式,突出了经验、性别和专业在工作量上的差异。这种方法为医疗系统提供了一种可扩展的、数据驱动的方法,以识别高危群体,并设计有针对性的干预措施,以减轻文档负担并提高EHR效率。

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