Quantifying the Impact of Trainee Providers on Outpatient Clinic Workflow using Secondary EHR Data

Providers today face productivity challenges including increased patient loads, increased clerical burdens from new government regulations and workflow impacts of electronic health records (EHR). Given these factors, methods to study and improve clinical workflow continue to grow in importance. Despite the ubiquitous presence of trainees in academic outpatient clinics, little is known about the impact of trainees on academic workflow. The purpose of this study is to demonstrate that secondary EHR data can be used to quantify that impact, with potentially important results for clinic efficiency and provider reimbursement models. Key findings from this study are that (1) Secondary EHR data can be used to reflect in clinic trainee activity, (2) presence of trainees, particularly in high-volume clinic sessions, is associated with longer session lengths, and (3) The timing of trainee appointments within clinic sessions impacts the session length.