Metrics for assessing physician activity using electronic health record log data

被引:105
作者
Sinsky, Christine A. [1 ]
Rule, Adam [2 ]
Cohen, Genna [3 ]
Arndt, Brian G. [4 ]
Shanafelt, Tait D. [5 ]
Sharp, Christopher D. [5 ,6 ]
Baxter, Sally L. [7 ,8 ]
Tai-Seale, Ming [9 ]
Yan, Sherry [10 ]
Chen, You [11 ]
Adler-Milstein, Julia [12 ]
Hribar, Michelle [2 ]
机构
[1] Amer Med Assoc, Dept Med, 515 N State St, Chicago, IL 60610 USA
[2] Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR USA
[3] Mathematica, Dept Med, Washington, DC USA
[4] Univ Wisconsin, Sch Med & Publ Hlth, Dept Family Med & Community Hlth, Madison, WI USA
[5] Stanford Univ, Dept Med, Div Hematol, Stanford, CA 94305 USA
[6] Stanford Univ, Dept Med, Div Gen Internal Med, Stanford, CA 94305 USA
[7] Univ Calif San Diego, Dept Biomed Informat, San Diego, CA USA
[8] Univ Calif San Diego, Shiley Eye Inst, Viterbi Family Dept Ophthalmol, San Diego, CA 92103 USA
[9] Univ Calif San Diego, Dept Family Med & Publ Hlth, San Diego, CA 92103 USA
[10] Sutter Hlth, Dept Med, Walnut Creek, CA USA
[11] Vanderbilt Univ, Med Ctr, Dept Biomed Informat, Nashville, TN USA
[12] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA
关键词
metric; operational efficiency; EHR log data; time studies; burnout; INFORMATION-TECHNOLOGY; CARE; TIME; BENEFITS; WORKLOAD; BURNOUT; BURDEN; MOTION;
D O I
10.1093/jamia/ocz223
中图分类号
TP [自动化技术、计算机技术];
学科分类号
0812 ;
摘要
Electronic health record (EHR) log data have shown promise in measuring physician time spent on clinical activities, contributing to deeper understanding and further optimization of the clinical environment. In this article, we propose 7 core measures of EHR use that reflect multiple dimensions of practice efficiency: total EHR time, work outside of work, time on documentation, time on prescriptions, inbox time, teamwork for orders, and an aspirational measure for the amount of undivided attention patients receive from their physicians during an encounter, undivided attention. We also illustrate sample use cases for these measures for multiple stakeholders. Finally, standardization of EHR log data measure specifications, as outlined here, will foster cross-study synthesis and comparative research.
引用
收藏
页码:639 / 643
页数:5
相关论文
共 37 条
[1]   HITECH Act Drove Large Gains In Hospital Electronic Health Record Adoption [J].
Adler-Milstein, Julia ;
Jha, Ashish K. .
HEALTH AFFAIRS, 2017, 36 (08) :1416-1422
[2]  
Adler-Milstein J, 2013, AM J MANAG CARE, V19, pSP345
[3]  
American Medical Association, CPT EV MAN
[4]   Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and TimeMotion Observations [J].
Arndt, Brian G. ;
Beasley, John W. ;
Watkinson, Michelle D. ;
Temte, Jonathan L. ;
Tuan, Wen-Jan ;
Sinsky, Christine A. ;
Gilchrist, Valerie J. .
ANNALS OF FAMILY MEDICINE, 2017, 15 (05) :419-426
[5]  
ASTM International, 2018, E214718 ASTM INT
[6]  
ASTM International, 2009, E214701 ASTM INT
[7]   Electronic medical records and physician stress in primary care: results from the MEMO Study [J].
Babbott, Stewart ;
Manwell, Linda Baier ;
Brown, Roger ;
Montague, Enid ;
Williams, Eric ;
Schwartz, Mark ;
Hess, Erik ;
Linzer, Mark .
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION, 2014, 21 (E1) :E100-E106
[8]   The impact of electronic health record systems on clinical documentation times: A systematic review [J].
Baumann, Lisa Ann ;
Baker, Jannah ;
Elshaug, Adam G. .
HEALTH POLICY, 2018, 122 (08) :827-836
[9]   The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview [J].
Black, Ashly D. ;
Car, Josip ;
Pagliari, Claudia ;
Anandan, Chantelle ;
Cresswell, Kathrin ;
Bokun, Tomislav ;
McKinstry, Brian ;
Procter, Rob ;
Majeed, Azeem ;
Sheikh, Aziz .
PLOS MEDICINE, 2011, 8 (01)
[10]   The Benefits Of Health Information Technology: A Review Of The Recent Literature Shows Predominantly Positive Results [J].
Buntin, Melinda Beeuwkes ;
Burke, Matthew F. ;
Hoaglin, Michael C. ;
Blumenthal, David .
HEALTH AFFAIRS, 2011, 30 (03) :464-471