Specialty and operator status influence electronic health record use variation

Area of Science:

• Health Informatics
• Medical Systems Analysis
• Physician Workflow Optimization

Background:

• Electronic health record (EHR) systems are integral to healthcare delivery.
• Physician workload and burnout are significant concerns linked to EHR use.
• Current EHR performance metrics may not adequately account for variations across different medical roles and specialties.

Purpose of the Study:

• To compare EHR utilization metrics between physicians with and without procedural roles.
• To investigate variations in EHR performance based on procedural status within different medical specialties.
• To inform the development of more nuanced EHR performance benchmarks.

Main Methods:

• A cross-sectional study analyzing 23 months of provider-level EHR data from an academic health system.
• Providers were categorized as 'operators' (performing procedures) or 'nonoperators'.
• Six key EHR metrics were compared: documentation timeliness, efficiency, and after-hours work ('pajama time').

Main Results:

• Operators exhibited higher rates of delayed cosign and verbal order completion compared to nonoperators.
• Pajama time and overall proficiency were similar between operators and nonoperators.
• Significant variations in EHR metrics were observed across medical specialties (medicine, pediatrics, obstetrics-gynecology) and procedural specialties, with ophthalmology operators showing high proficiency but also increased delays.

Conclusions:

• EHR utilization patterns differ significantly based on a physician's procedural status and specialty.
• Standardized, uniform EHR performance benchmarks may be inappropriate.
• Workflow-specific optimization strategies are necessary to address variations in EHR use and mitigate physician burnout.