Chen Junye George, Lai Hao Xing, Wong Shi Min, Pan Terry Ling Te, Lim Er Luen, Liau Zi Qiang Glen
Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
National University Polyclinics Headquarters, Singapore, Singapore.
JMIR Form Res. 2025 Jun 20;9:e68491. doi: 10.2196/68491.
Since Singapore's first migration to Epic in 2022, we have been conducting an advanced Epic personalization course twice a year for health care professionals with at least 3 months of experience using the system. Electronic medical records education is an under-recognized pillar in reducing health information technology-related stress and clinician burnout.
The intent of the course is to improve clinician efficiency through customization and personalization of Epic interfaces. We hypothesized that compared to their colleagues, trained clinicians would demonstrate significant quantitative improvements in use of the Epic system after our course.
We performed a retrospective analysis from July 2022 to January 2024, including 17 clinicians among 77 individuals who attended our course. Recruitment was done through digital mailers sent out via the local hospital announcement channels. Interested clinicians were able to register for our course via the National University Of Singapore website. Our one-day course involves physical lessons and interprofessional, case-based discussions emphasizing a wide range of high-yield Epic functionalities with practice exercises, such as drafting referral letter templates. Three months of pre- and postcourse Epic usage statistics of the trained clinicians were retrieved based on aggregate data provided by Epic Singapore. Performance metrics included documentation length, time spent in Epic functionalities and use of SmartPhrases, order sets and preference lists.
At three months post-course, documentation length decreased by 45.8% (711.8 characters) compared to a 22.2% (126.4 characters) increase among controls. Trained clinicians demonstrated a 2.47-fold increase in use of order sets from 16.2% to 40%, and a 49.9% increase in orders from preference lists after the course, from 35.1% to 52.6%. In total, trained clinicians demonstrated a 1.8-fold increase in combined use of orders from preference lists or order sets after the course, from 51.4% to 92.6%. The number of SmartPhrases created by trained clinicians was 5.64 times higher than among controls, in addition to a 5.57-fold higher use of Quick Filters than controls. Moreover, time in the Chart Review section per day decreased by 29.3% (4.6 min) among trained clinicians versus an increase of 14.6% (2.8 min) among controls. Compared to controls, trained clinicians spent 36.7% (219.6 min) less time in the Epic system per day, 56.6% (29 min) less time on Notes per day, and 57.5% (10.7 min) less time on orders per day.
Overall, trained clinicians demonstrated more efficiency in their use of Epic, with reduced time spent across various functionalities. Increased use of Smart Tools, including SmartPhrases and Quick Filters was also observed among trained clinicians, which indicated efficiency in reducing total usage time. These findings demonstrated broad improvements across multiple physician efficiency metrics among participating clinicians of our advanced Epic personalization course. These gains may contribute to improved mental health among health care professionals and enhanced productivity within health care systems.
自2022年新加坡首次迁移至Epic系统以来，我们每年为有至少3个月该系统使用经验的医疗保健专业人员举办两次高级Epic个性化课程。电子病历教育是减轻与健康信息技术相关的压力和临床医生职业倦怠的一个未得到充分认识的支柱。
该课程的目的是通过定制和个性化Epic界面来提高临床医生的效率。我们假设，与他们的同事相比，经过培训的临床医生在我们的课程结束后，在使用Epic系统方面将表现出显著的量化改善。
我们进行了一项回顾性分析，时间跨度为2022年7月至2024年1月，包括参加我们课程的77人中的17名临床医生。招募是通过当地医院公告渠道发送的数字邮件进行的。感兴趣的临床医生能够通过新加坡国立大学网站注册我们的课程。我们为期一天的课程包括实体课程以及跨专业的、基于案例的讨论，强调通过练习（如起草转诊信模板）来掌握广泛的高收益Epic功能。根据新加坡Epic提供的汇总数据，获取了经过培训的临床医生在课程前后三个月的Epic使用统计数据。绩效指标包括文档长度、在Epic功能中花费的时间以及智能短语、医嘱集和偏好列表的使用情况。
课程结束三个月后，与对照组增加22.2%（126.4个字符）相比，文档长度减少了45.8%（711.8个字符）。经过培训的临床医生在课程结束后，医嘱集的使用从16.2%增加到40%，增长了2.47倍，偏好列表中的医嘱从35.1%增加到52.6%，增长了49.9%。总体而言，经过培训的临床医生在课程结束后，偏好列表或医嘱集的联合使用从51.4%增加到92.6%，增长了1.8倍。经过培训的临床医生创建的智能短语数量比对照组高5.6倍，快速过滤器的使用比对照组高5.57倍。此外，经过培训的临床医生每天在图表审查部分花费的时间减少了29.3%（4.6分钟），而对照组增加了14.6%（2.8分钟）。与对照组相比，经过培训的临床医生每天在Epic系统中花费的时间减少了36.7%（219.6分钟），每天在记录上花费的时间减少了56.6%（29分钟），每天在医嘱上花费的时间减少了57.5%（10.7分钟）。
总体而言，经过培训的临床医生在使用Epic方面表现出更高的效率，在各种功能上花费的时间减少。在经过培训的临床医生中还观察到智能工具（包括智能短语和快速过滤器）的使用增加，这表明在减少总使用时间方面的效率。这些发现表明，在我们的高级Epic个性化课程的参与临床医生中，多个医生效率指标有广泛改善。这些收获可能有助于改善医疗保健专业人员的心理健康，并提高医疗保健系统内的生产力。
