TY - JOUR
T1 - Effect of restricting electronic health records on clinician efficiency
T2 - substudy of a randomized clinical trial
AU - Kneifati-Hayek, Jerard Z.
AU - Applebaum, Jo R.
AU - Schechter, Clyde B.
AU - Col, Alexis Dal
AU - Salmasian, Hojjat
AU - Southern, William N.
AU - Adelman, Jason S.
N1 - Funding Information:
This project was supported by grant numbers T32HS026121 and R21HS023704 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. The Agency of Healthcare Research and Quality had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Publisher Copyright:
© The Author(s) 2023.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - A prior randomized controlled trial (RCT) showed no significant difference in wrong-patient errors between clinicians assigned to a restricted electronic health record (EHR) configuration (limiting to 1 record open at a time) versus an unrestricted EHR configuration (allowing up to 4 records open concurrently). However, it is unknown whether an unrestricted EHR configuration is more efficient. This substudy of the RCT compared clinician efficiency between EHR configurations using objective measures. All clinicians who logged onto the EHR during the substudy period were included. The primary outcome measure of efficiency was total active minutes per day. Counts were extracted from audit log data, and mixed-effects negative binomial regression was performed to determine differences between randomized groups. Incidence rate ratios (IRRs) were calculated with 95% confidence intervals (CIs). Among a total of 2556 clinicians, there was no significant difference between unrestricted and restricted groups in total active minutes per day (115.1 vs 113.3 min, respectively; IRR, 0.99; 95% CI, 0.93-1.06), overall or by clinician type and practice area.
AB - A prior randomized controlled trial (RCT) showed no significant difference in wrong-patient errors between clinicians assigned to a restricted electronic health record (EHR) configuration (limiting to 1 record open at a time) versus an unrestricted EHR configuration (allowing up to 4 records open concurrently). However, it is unknown whether an unrestricted EHR configuration is more efficient. This substudy of the RCT compared clinician efficiency between EHR configurations using objective measures. All clinicians who logged onto the EHR during the substudy period were included. The primary outcome measure of efficiency was total active minutes per day. Counts were extracted from audit log data, and mixed-effects negative binomial regression was performed to determine differences between randomized groups. Incidence rate ratios (IRRs) were calculated with 95% confidence intervals (CIs). Among a total of 2556 clinicians, there was no significant difference between unrestricted and restricted groups in total active minutes per day (115.1 vs 113.3 min, respectively; IRR, 0.99; 95% CI, 0.93-1.06), overall or by clinician type and practice area.
KW - audit log data
KW - efficiency
KW - electronic health record
UR - http://www.scopus.com/inward/record.url?scp=85152971346&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85152971346&partnerID=8YFLogxK
U2 - 10.1093/jamia/ocad025
DO - 10.1093/jamia/ocad025
M3 - Article
C2 - 37011638
AN - SCOPUS:85152971346
SN - 1067-5027
VL - 30
SP - 953
EP - 957
JO - Journal of the American Medical Informatics Association : JAMIA
JF - Journal of the American Medical Informatics Association : JAMIA
IS - 5
ER -