scholarly journals National estimates of the impact of electronic health records on the workload of primary care physicians

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Jaeyong Bae ◽  
William E. Encinosa
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Primary Care Physicians ◽  
Health Records ◽  
National Estimates ◽  
Electronic Health ◽  
The Impact

scholarly journals Sexually Transmitted Infections, the Epidemic That Persists After the COVID-19 Pandemic: a Time-series Analysis of the Primary Care Electronic Health Records Covering About 5 Million People in Catalonia

2021 ◽  
Author(s):  
Carolina Guiriguet ◽  
Mireia Alberny ◽  
Ermengol Coma ◽  
Carme Roca ◽  
Francesc Fina ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Electronic Health Records ◽  
Sexually Transmitted Infections ◽  
Control Measures ◽  
Health Records ◽  
Future Evolution ◽  
Sexually Transmitted ◽  
Electronic Health ◽  
The Impact

Abstract Background: The COVID-19 pandemic and related control measures have affected the diagnosis of other diseases, including sexually transmitted infections (STI). Our aim is to analyse the impact of the COVID-19 pandemic on the incidence of STI diagnosed in primary care.Methods: Time-series study of STI, using data from primary care electronic health records in Catalonia (Spain) from January 2016 to March 2021. We obtained the monthly expected incidence of STI using a temporary regression, where the response variable was the incidence of STI from 2016 to 2019 and the adjustment variables were the trend and seasonality of the time series. Excess or reduction of STI were defined as the number of observed minus the expected cases, globally and stratified by age, sexe, type of STI and socioeconomic status.Results: Between March 2020 and March 2021 we observed a reduction of 20.2% (95% CI: 13.0% to 25.8%) on STI diagnoses compared to the expected. This reduction was greater during the lockdown period (-39%), in women (-26.5%), in people aged under 60 years (up to -22.4% in people aged 30-59 years), less deprived areas (-24%) and some types of STI, specially chlamydia (-32%), gonorrhea (-30.7%) and HIV (-21.5%). Conversely, syphilis and non-specific STI were those with lesser reductions with -3.6% and -7.2%, respectively,Conclusions: The COVID-19 pandemic has impacted on STI incidence, reducing the number of diagnoses performed in primary care and raising concerns about future evolution of STI trends. Those STI that are less symptomatic or diagnosed through screening will deserve special attention regarding potential diagnostic delays.

scholarly journals Factors Associated With Electronic Health Record Usage Among Primary Care Physicians After Hours: Retrospective Cohort Study

10.2196/13779 ◽  
2019 ◽  
Vol 6 (3) ◽  
pp. e13779 ◽  
Author(s):  
Selasi Attipoe ◽  
Yungui Huang ◽  
Sharon Schweikhart ◽  
Steve Rust ◽  
Jeffrey Hoffman ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Published Data ◽  
Health Records ◽  
Dominant Source ◽  
Factors Associated ◽  
After Hours ◽  
Electronic Health

Background There is limited published data on variation in physician usage of electronic health records (EHRs), particularly after hours. Research in this area could provide insight into the effects of EHR-related workload on physicians. Objective This study sought to examine factors associated with after-hours EHR usage among primary care physicians. Methods Electronic health records usage information was collected from primary care pediatricians in a large United States hospital. Inclusion criteria consisted solely of being a primary care physician who started employment with the hospital before the study period, so all eligible primary care physicians were included without sampling. Mixed effects statistical modeling was used to investigate the effects of age, gender, workload, normal-hour usage, week to week variation, and provider-to-provider variation on the after-hour usage of EHRs. Results There were a total of 3498 weekly records obtained on 50 physicians, of whom 22% were male and 78% were female. Overall, more EHR usage during normal work hours was associated with decreased usage after hours. The more work relative value units generated by physicians, the more time they spent interacting with EHRs after hours (β=.04, P<.001) and overall (ie, during normal hours and after hours) (β=.24, P<.001). Gender was associated with total usage time, with females spending more time than males (P=.03). However, this association was not observed with after-hours EHR usage. provider-to-provider variation was the largest and most dominant source of variation in after-hour EHR usage, which accounted for 52% of variance of total EHR usage. Conclusion The present study found that there is a considerable amount of variability in EHR use among primary care physicians, which suggested that many factors influence after-hours EHR usage by physicians. However, provider-to-provider variation was the largest and most dominant source of variation in after-hours EHR usage. While the results are intuitive, future studies should consider the effect of EHR use variations on workload efficiency.

scholarly journals Factors Associated With Electronic Health Record Usage Among Primary Care Physicians After Hours: Retrospective Cohort Study (Preprint)

2019 ◽  
Author(s):  
Selasi Attipoe ◽  
Yungui Huang ◽  
Sharon Schweikhart ◽  
Steve Rust ◽  
Jeffrey Hoffman ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Published Data ◽  
Health Records ◽  
Dominant Source ◽  
Factors Associated ◽  
After Hours ◽  
Electronic Health

BACKGROUND There is limited published data on variation in physician usage of electronic health records (EHRs), particularly after hours. Research in this area could provide insight into the effects of EHR-related workload on physicians. OBJECTIVE This study sought to examine factors associated with after-hours EHR usage among primary care physicians. METHODS Electronic health records usage information was collected from primary care pediatricians in a large United States hospital. Inclusion criteria consisted solely of being a primary care physician who started employment with the hospital before the study period, so all eligible primary care physicians were included without sampling. Mixed effects statistical modeling was used to investigate the effects of age, gender, workload, normal-hour usage, week to week variation, and provider-to-provider variation on the after-hour usage of EHRs. RESULTS There were a total of 3498 weekly records obtained on 50 physicians, of whom 22% were male and 78% were female. Overall, more EHR usage during normal work hours was associated with decreased usage after hours. The more work relative value units generated by physicians, the more time they spent interacting with EHRs after hours (β=.04, <italic>P</italic>&lt;.001) and overall (ie, during normal hours and after hours) (β=.24, <italic>P</italic>&lt;.001). Gender was associated with total usage time, with females spending more time than males (<italic>P</italic>=.03). However, this association was not observed with after-hours EHR usage. provider-to-provider variation was the largest and most dominant source of variation in after-hour EHR usage, which accounted for 52% of variance of total EHR usage. CONCLUSION The present study found that there is a considerable amount of variability in EHR use among primary care physicians, which suggested that many factors influence after-hours EHR usage by physicians. However, provider-to-provider variation was the largest and most dominant source of variation in after-hours EHR usage. While the results are intuitive, future studies should consider the effect of EHR use variations on workload efficiency.

scholarly journals Satisfaction with electronic health records is associated with job satisfaction among primary care physicians

2013 ◽  
Vol 21 (1) ◽  
pp. 18 ◽  
Author(s):  
Christine D Jones ◽  
George M Holmes ◽  
Sarah E Lewis ◽  
Kristie W Thompson ◽  
Samuel Cykert ◽  
...  
Keyword(s):  
Primary Care ◽  
Job Satisfaction ◽  
Electronic Health Records ◽  
Primary Care Physicians ◽  
Health Records ◽  
Electronic Health

scholarly journals Electronic Health Records’ Support for Primary Care Physicians’ Situation Awareness: A Metanarrative Review

2021 ◽  
pp. 001872082110143
Author(s):  
April Savoy ◽  
Himalaya Patel ◽  
Daniel R. Murphy ◽  
Ashley N. D. Meyer ◽  
Jennifer Herout ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Electronic Health Records ◽  
Situation Awareness ◽  
Primary Care Physicians ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Health Records ◽  
Care Plans ◽  
Electronic Health

Objective Situation awareness (SA) refers to people’s perception and understanding of their dynamic environment. In primary care, reduced SA among physicians increases errors in clinical decision-making and, correspondingly, patients’ risk of experiencing adverse outcomes. Our objective was to understand the extent to which electronic health records (EHRs) support primary care physicians (PCPs)’ SA during clinical decision-making. Method We conducted a metanarrative review of papers in selected academic databases, including CINAHL and MEDLINE. Eligible studies included original peer-reviewed research published between January 2012 and August 2020 on PCP–EHR interactions. We iteratively queried, screened, and summarized literature focused on EHRs supporting PCPs’ clinical decision-making and care management for adults. Then, we mapped findings to an established SA framework to classify external factors (individual, task, and system) affecting PCPs’ levels of SA (1–Perception, 2–Comprehension, and 3–Projection) and identified SA barriers. Results From 1504 articles identified, we included and synthesized 19 studies. Study designs were largely noninterventional. Studies described EHR workflow misalignments, usability issues, and communication challenges. EHR information, including lab results and care plans, was characterized as incomplete, untimely, or irrelevant. Unmet information needs made it difficult for PCPs to obtain even basic SA, Level 1 SA. Prevalent barriers to PCPs developing SA with EHRs were errant mental models, attentional tunneling, and data overload. Conclusion Based on our review, EHRs do not support the development of higher levels of SA among PCPs. Review findings suggest SA-oriented design processes for health information technology could improve PCPs’ SA, satisfaction, and decision-making.

scholarly journals Overcoming Barriers to Implementing Electronic Health Records in Rural Primary Care Clinics

2017 ◽  
Author(s):  
Patricia Mason ◽  
Roger Mayer ◽  
Wen-Wen Chien ◽  
Judith Monestime
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Change Management ◽  
Complex Adaptive Systems ◽  
Information Exchange ◽  
Primary Care Physicians ◽  
Physician Assistants ◽  
Health Records ◽  
Rural Primary Care ◽  
Electronic Health

Medicare-eligible physicians at primary care practices (PCP) that did not implement an electronic health record (EHR) system by the end of 2015 face stiff penalties. One year prior to the 2015 deadline, approximately half of all primary clinics have not implemented a basic EHR system. The purpose of this phenomenology study was to explore rural primary care physicians and physician assistants’ experiences regarding overcoming barriers to implementing EHRs. Complex adaptive systems formed the conceptual framework for this study. Data were collected through face-to-face interviews with a purposeful sample of 21 physicians and physician assistants across 2 rural PCPs in the southeastern region of Missouri. Participant perceptions were elicited regarding overcoming barriers to implementing EHRs systems as manadated by federal legislation. Interview questions were transcribed and processed through qualitative software to discern themes of how rural PCP physicians and physician assistants might overcome barriers to implementing electronic health records. Through the exploration of the narrative segments, 4 emergent themes were common among the participants including (a) limited finances to support EHRs, (b) health information exchange issues, (c) lack of business education, and (d) lack of change management at rural medical practices. This study may provide rural primary care physicians and administrators with strategies to promote the adoption of EHRs, provide cost efficient business services, and improve change management plans.

scholarly journals The Impact of Electronic Health Records on Workflow and Financial Measures in Primary Care Practices

2013 ◽  
Vol 49 (1pt2) ◽  
pp. 405-420 ◽  
Author(s):  
Neil S. Fleming ◽  
Edmund R. Becker ◽  
Steven D. Culler ◽  
Dunlei Cheng ◽  
Russell McCorkle ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Health Records ◽  
Financial Measures ◽  
Care Practices ◽  
Electronic Health ◽  
Primary Care Practices ◽  
The Impact

scholarly journals Impact of the COVID-19 pandemic and related control measures on cancer diagnosis in Catalonia: a time-series analysis of primary care electronic health records covering about five million people

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047567
Author(s):  
Ermengol Coma ◽  
Carolina Guiriguet ◽  
Nuria Mora ◽  
Mercè Marzo-Castillejo ◽  
Mencia Benítez ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Electronic Health Records ◽  
Malignant Neoplasm ◽  
Control Measures ◽  
Malignant Neoplasms ◽  
Health Records ◽  
Incidence Of Cancer ◽  
Electronic Health ◽  
The Impact

ObjectiveCancer care has been disrupted by the response of health systems to the COVID-19 pandemic, especially during lockdowns. The objective of our study is to evaluate the impact of the pandemic on the incidence of cancer diagnoses in primary care.DesignTime-series study of malignant neoplasms and diagnostic procedures, using data from the primary care electronic health records from January 2014 to September 2020.SettingPrimary care, Catalonia, Spain.ParticipantsPeople older than 14 years and assigned in one of the primary care practices of the Catalan Institute of Health with a new diagnosis of malignant neoplasm.Main outcome measuresWe obtained the monthly expected incidence of malignant neoplasms using a temporary regression, where the response variable was the incidence of cancer from 2014 to 2018 and the adjustment variables were the trend and seasonality of the time series. Excess or lack of malignant neoplasms was defined as the number of observed minus expected cases, globally and stratified by sex, age, type of cancer and socioeconomic status.ResultsBetween March and September 2020 we observed 8766 (95% CI 4135 to 13 397) fewer malignant neoplasm diagnoses, representing a reduction of 34% (95% CI 19.5% to 44.1%) compared with the expected. This underdiagnosis was greater in individuals aged older than 64 years, men and in some types of cancers (skin, colorectal, prostate). Although the reduction was predominantly focused during the lockdown, expected figures have not yet been reached (40.5% reduction during the lockdown and 24.3% reduction after that).ConclusionsReduction in cancer incidence has been observed during and after the lockdown. Urgent policy interventions are necessary to mitigate the indirect effects of the COVID-19 pandemic and related control measures on other diseases and some strategies must be designed in order to reduce the underdiagnosis of cancer.

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