Consistency is key: documentation distribution and efficiency in primary care.

Area of Science:

• Health Informatics
• Clinical Workflow Optimization
• Primary Care Practice Management

Background:

• Electronic Health Record (EHR) systems are integral to modern primary care.
• Variations in daily documentation practices among clinicians are common.
• Understanding documentation patterns is crucial for improving efficiency and reducing clinician burden.

Purpose of the Study:

• To analyze the variability of daily documentation patterns in primary care.
• To determine if specific patterns, consistency, and deviations are associated with note-writing efficiency.
• To identify factors influencing clinician efficiency in EHR documentation.

Main Methods:

• Utilized EHR active use data from Oracle Cerner Advance for 498 clinicians.
• Employed k-means clustering to identify 8 distinct daily documentation patterns.
• Analyzed the relationship between documentation patterns, consistency, deviations, and note-writing efficiency.

Main Results:

• Identified 8 distinct daily documentation patterns, with 3 common ones accounting for 80.6% of clinician days.
• Clinicians with high consistency (>80% of days in a single pattern) showed significantly higher documentation efficiency.
• Deviations from a clinician's usual pattern were associated with decreased documentation efficiency.

Conclusions:

• Substantial variation in efficiency exists across different daily documentation patterns.
• Clinician-level factors, particularly consistency in documentation, are key to efficiency.
• Organizational leaders should support consistent daily documentation practices to reduce burden.