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Efficiency of Emergency Physicians: Insights from an Observational Study using EHR Log Files

Year: 2018

Type: article

Abstract: OBJECTIVE: With federal mandates and incentives since the turn of this decade, electronic health records (EHR) have been widely adopted and used for clinical care. Over the last several years, we have seen both positive and negative perspectives on its use. Using an analysis of log files of EHR use, we investigated the nature of EHR use and their effect on an emergency department's (ED) throughput and efficiency. METHODS: = 2,304 patients) were collected. For each patient encounter, physician activities in the EHR were categorized into four activities: documentation, review, orders, and navigation. Four ED-based performance metrics were also captured: door-to-provider time, door-to-doctor time, door-to-disposition time, and length of stay (LOS). Association between the four EHR-based activities and corresponding ED performance metrics were evaluated. RESULTS: < 0.05). There were no statistically significant associations between any of the other performance metrics and EHR activities. CONCLUSION: The results highlight that longer time spent on reviewing information on the EHR is potentially associated with decreased ED throughput efficiency. Balancing these competing goals is often a challenge of physicians, and its implications for patient safety is discussed.

Source: Applied Clinical Informatics

DOI: 10.1055/s-0037-1621705

Authors: Thomas Kannampallil, Courtney Denton, Jason Shapiro, Vimla Patel

Institutions: University of Illinois Chicago, New York Academy of Medicine, Icahn School of Medicine at Mount Sinai

Language: English

Topic: Electronic Health Records Systems

Subfield: Health Information Management

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funder: Agency for Healthcare Research and Quality