Improving physician wellness through electronic health record education

2021 ◽  
pp. 009121742110346
Author(s):  
Elizabette Johnson ◽  
Elizabeth Roth
Keyword(s):  
Electronic Health Record ◽  
Statistical Significance ◽  
Resident Physician ◽  
Health Record ◽  
Physician Burnout ◽  
Paired Data ◽  
Post Intervention ◽  
Physician Wellness ◽  
Resident Wellness ◽  
Electronic Health

Objective Our goal is to improve the wellness of our Family Medicine residents now and in the future by educating them on more efficient use of our electronic health record (EHR). Resident physician burnout is a significant problem and is correlated with time spent using an EHR after work hours. Family physicians have the highest rate of burnout of all specialties, and the EHR is a significant contributor to this burnout. Studies have shown that increased EHR education can improve job satisfaction. Method Over 5 months, we provided weekly brief (15 minute) educational sessions covering 6 topics twice and a one-hour individualized meeting of each resident physician with an EHR trainer. We evaluated our intervention with wellness surveys and objective measures of EHR efficiency both pre and post intervention. We further evaluated efficiency by comparing pre and post-intervention values of the following: average keystrokes, mouseclicks, accelerator use, minutes per encounter and percent closed encounters at month’s end. Results Resident questionnaires showed lessons increased knowledge and intention to use EHR accelerators, but this was not statistically significant. Analysis of objective data showed most efficiency metrics worsened, though most not to a degree that was statistically significant. Residents reported subjective increases in efficiency, and paired data from wellness surveys showed an overall decrease in burnout post-intervention vs. baseline. Conclusions Much of the data in this pilot study does not reach statistical significance, but is highly suggestive that increased EHR training can improve at least perceived efficiency and thereby resident wellness.

scholarly journals Electronic Health Record Use among Ophthalmology Residents while on Call

2020 ◽  
Vol 12 (02) ◽  
pp. e143-e150
Author(s):  
Christopher P. Long ◽  
Ming Tai-Seale ◽  
Robert El-Kareh ◽  
Jeffrey E. Lee ◽  
Sally L. Baxter
Keyword(s):  
Internal Medicine ◽  
Electronic Health Record ◽  
Chart Review ◽  
Health Record ◽  
Physician Burnout ◽  
Single Institution ◽  
Clinical Exposure ◽  
Future Studies ◽  
After Hours ◽  
Electronic Health

Abstract Background As electronic health record (EHR) use becomes more widespread, detailed records of how users interact with the EHR, known as EHR audit logs, are being used to characterize the clinical workflows of physicians including residents. After-hours EHR use is of particular interest given its known association with physician burnout. Several studies have analyzed EHR audit logs for residents in other fields, such as internal medicine, but none thus far in ophthalmology. Here, we focused specifically on EHR use during on-call shifts outside of normal clinic hours. Methods In this retrospective study, we analyzed raw EHR audit log data from on-call shifts for 12 ophthalmology residents at a single institution over the course of a calendar year. Data were analyzed to characterize total time spent using the EHR, clinical volume, diagnoses of patients seen on call, and EHR tasks. Results Across all call shifts, the median and interquartile range (IQR) of the time spent logged into the EHR per shift were 88 and 131 minutes, respectively. The median (IQR) unique patient charts accessed per shift was 7 (9) patients. When standardized to per-hour measures, weekday evening shifts were the busiest call shifts with regard to both EHR use time and clinical volume. Total EHR use time and clinical volume were greatest in the summer months (July to September). Chart review comprised a majority (63.4%) of ophthalmology residents' on-call EHR activities. Conclusion In summary, EHR audit logs demonstrate substantial call burden for ophthalmology residents outside of regular clinic hours. These data and future studies can be used to further characterize the clinical exposure and call burden of ophthalmology residents and could potentially have broader implications in the fields of physician burnout and education policy.

scholarly journals Back to the Future: Portable Word Processors and the Electronic Health Record

2019 ◽  
Vol 34 (s1) ◽  
pp. s104-s105
Author(s):  
Alfredo Mori
Keyword(s):  
Electronic Health Record ◽  
Emergency Departments ◽  
Extreme Environments ◽  
Health Record ◽  
Physician Burnout ◽  
Software And Hardware ◽  
Electronic Health ◽  
Professional Writers ◽  
Word Processors

Introduction:The Electronic Health Record (EHR) is now the standard means for recording and maintaining medical notes in most emergency departments. The EHR is an independent cause of physician burnout, and maintenance of the EHR may occupy 30 to 50% of clinical time. There are software solutions available, but they are connected to fixed, expensive, distracting, and bright electronically powered computers. Scribes have been successfully trialed, but are also expensive and attached to computers on wheels. Portable digital word processors in the form of the AlphaSmart Neo is a redundant technology designed primarily for children with typing difficulties. It has recently enjoyed a resurgence in popularity among professional writers, journalists, and field researchers for the ultimate distraction-free writing experience. The Alphasmart Neo is cheap, nearly indestructible, intuitive, and requires almost no recharging. It is compatible with all software across Mac OS, Windows, and Linux. Notes are entered by the clinician or scribe, independently of computers, at the bedside, and uploaded to any software via USB cable.Aim:To describe the introduction and impact of the AlphaSmart Neo on the EHR in emergency departments across Australia.Methods:We will examine the role of the Alphasmart Neo in austere, low power, extreme environments with a demonstration on how to enter, maintain, and transfer an electronic health record independent of any computer or power source.Discussion:We believe the AlphaSmart Neo is an ideal, personalized, cheap, effective, and efficient hardware solution to entering notes independent of other software and hardware. It is distraction free at the patient’s bedside, resulting in better notes that the clinician enjoys writing.

Physician Burnout in the Electronic Health Record Era

2019 ◽  
Vol 170 (3) ◽  
pp. 216 ◽  
Author(s):  
N. Lance Downing ◽  
David W. Bates ◽  
Christopher A. Longhurst
Keyword(s):  
Electronic Health Record ◽  
Health Record ◽  
Physician Burnout ◽  
Electronic Health

Abstract MP12: Electronic Health Record-Based Assessment of Cardiovascular Health

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Randi E Foraker ◽  
Abigail B Shoben ◽  
Albert M Lai ◽  
Philip R Payne ◽  
Marjorie Kelley ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Cardiovascular Health ◽  
Normal Weight ◽  
Health Record ◽  
Visualization Tool ◽  
Obese Women ◽  
Intervention Period ◽  
Post Intervention ◽  
The Mean ◽  
Electronic Health

INTRODUCTION: An electronic health record (EHR)-based visualization tool was developed to facilitate patient-provider communication around the American Heart Association’s (AHA) Life’s Simple 7™ for cardiovascular health (CVH). The tool automatically populates with patient data from the EHR and utilizes a stoplight color scheme to indicate “ideal” (green), “intermediate” (yellow), and “poor” (red) CVH. METHODS: CVH was defined for smoking, body mass index, blood pressure, and cholesterol according to AHA criteria. For this analysis, diabetes was characterized as either yellow (treated) or green (untreated), as most patients were missing fasting glucose values. An overall CVH score was calculated and ranged from 0 (worst) to 10 (best) by summing across behaviors and factors as follows: poor, 0; intermediate, 1; and ideal, 2. The CVH tool first launched within the EHR of our outpatient intervention clinic in October 2013. The change in CVH of female patients ages 65 and older seen in the clinic during the pre-intervention period (May 1 - July 31, 2013) and the post-intervention period (May 1 - July 31, 2014) was described. RESULTS: One hundred nine women (average age 74 years; 35% black), seen pre- and post-intervention, were enrolled in the study. The mean CVH score was 6.0 and the mean fractional score (actual score/maximum possible) was 0.63 at both time points, and neither differed significantly by race. Figure 1 shows the distribution of ideal, intermediate, poor, and missing CVH values for each behavior and factor in 2013 and 2014. From 2013 to 2014, the proportion of obese women decreased from 47% to 43%, and the proportion of normal-weight women increased from 15% to 19%. Favorable changes were also seen for diabetes. CONCLUSIONS: This is the first study to develop and implement an EHR-based CVH visualization tool. Our study demonstrates that it is feasible to implement patient-centered EHR-based tools at the point-of-care in the primary care setting. Future work is needed to assess how to best harness the potential of such tools.

Physician Burnout in the Electronic Health Record Era: Are We Ignoring the Real Cause?

2018 ◽  
Vol 169 (1) ◽  
pp. 50 ◽  
Author(s):  
N. Lance Downing ◽  
David W. Bates ◽  
Christopher A. Longhurst
Keyword(s):  
Electronic Health Record ◽  
Health Record ◽  
Physician Burnout ◽  
The Real ◽  
Electronic Health

Abstract 15537: An Electronic Health Record Intervention to Optimize Utilization of Transthoracic Echocardiography: Opportunity for Cost Savings in the Era of Value Based-care

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jason Castaneda ◽  
corey rearick ◽  
Joseph Weber ◽  
Eve Edstrom ◽  
Kimisha Cassidy ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Transthoracic Echocardiography ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cost Savings ◽  
Health Record ◽  
Post Intervention ◽  
Academic Medical ◽  
Electronic Health ◽  
Value Based Care

Introduction: In the current value-based era, targeting diagnostic resources and minimizing unnecessary testing is of paramount importance. Transthoracic echocardiography (TTE) is a common and costly test, and available Appropriate Use Criteria (AUC) guide optimal utilization. Limited TTE (L-TTE) shortens sonographer time, lowers cost and may be ideal for repeat TTEs (R-TTE) with a focused indication. However, many clinicians are unfamiliar with the AUC and opportunities for L-TTE. We prospectively tested an Electronic Health Record (EHR)-based intervention aimed at optimizing TTE utilization in a large academic medical center. Methods: TTE utilization at the University of Chicago Medicine was assessed over a 6-month period and complete TTE (C-TTE), L-TTE and R-TTE (TTE repeated within 6 months) were recorded. An EHR-based intervention was then implemented and TTE utilization was assessed over the ensuing 8 weeks. The intervention included presenting new descriptive L-TTE options (i.e. “Limited TTE: EF or Effusion Only”) when any “echo” was searched in the EHR order panel, an alert to prior TTEs (i.e. date & LVEF) and a link to AUC-based guidance for TTE ordering. Educational materials were also distributed to frequent TTE ordering providers. Results: Among 9121 TTEs (53% inpatient) pre-intervention , 11% (n=1002) were L-TTEs and 25% (n=2320) were R-TTEs. There were more L-TTEs and R-TTEs in pre-intervention inpatients compared to outpatients (L-TTE 14% vs 7%, p<0.0001, R-TTE 33% vs 17%, p<0.0001). Post-intervention (2879 TTEs, 53% inpatient), R-TTEs significantly decreased (22.6% vs 25.4%, p=0.0019) and L-TTEs significantly increased (14% vs 11%, p<0.0001) compared to pre-intervention, with inpatient TTEs most impacted (R-TTE 28% vs 33%, p=0.0016, L-TTE 19% vs 14%, p<0.001). The intervention’s greatest impact was to markedly increase L-TTEs among inpatient R-TTEs (44% vs 35%, p=0.0002). Conclusions: Despite AUC discouraging frequent repeat TTEs, R-TTEs are common in an academic medical center and utilization of L-TTE is rare. An EHR-based intervention with prior TTE alerts and descriptive L-TTE options increases L-TTEs and reduces R-TTEs. Further study is warranted to describe the full clinical and financial impact of this intervention.

scholarly journals The influence of a Sprint optimization and training intervention on time spent in the electronic health record (EHR)

JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Amber Sieja ◽  
Melanie D Whittington ◽  
Vanessa Paul Patterson ◽  
Katie Markley ◽  
Heather Holmstrom ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Interrupted Time Series ◽  
Health Record ◽  
Full Time ◽  
Full Time Equivalent ◽  
Post Intervention ◽  
Time Savings ◽  
Electronic Health ◽  
The Impact ◽  
And Training

Abstract Objective We report the influence of Sprint electronic health record (EHR) training and optimization on clinician time spent in the EHR. Materials and Methods We studied the Sprint process in one academic internal medicine practice with 26 providers. Program offerings included individualized training sessions, and the ability to clean up, fix, or build new EHR tools during the 2-week intervention. EHR usage log data were available for 24 clinicians, and the average clinical full-time equivalent was 0.44. We used a quasi-experimental study design with an interrupted time series specification, with 8 months of pre- and 12 months of post-intervention data to evaluate clinician time spent in the EHR. Results We discovered a greater than 6 h per day reduction in clinician time spent in the EHR at the clinic level. At the individual clinician level, we demonstrated a time savings of 20 min per clinician per day among those who attended at least 2 training sessions. Discussion We can promote EHR time savings for clinicians who engage in robust EHR training and optimization programs. To date, programs have shown a positive correlation between participation and subjective EHR satisfaction, efficiency, or time saved. The impact of EHR training and optimization on objective time savings remains elusive. By measuring time in the EHR, this study contributes to an ongoing conversation about the resources and programs needed to decrease clinician EHR time. Conclusions We have demonstrated that Sprint is associated with time savings for clinicians for up to 6 months. We suggest that an investment in EHR optimization and training can pay dividends in clinician time saved.

Sign in / Sign up

Export Citation Format

Share Document