Association Between CMS Student Note Policy Implementation and Physician Note Editing Time.

Area of Science:

• Medical Education
• Health Informatics
• Clinical Documentation

Background:

• Medical student documentation is a key professional activity but opportunities are limited.
• A policy change enabled physician billing for student notes, prompting integration into daily workflows.
• This study assesses the impact of student note-writing on resident and attending physician documentation time.

Purpose of the Study:

• To evaluate the effect of integrating medical student documentation into electronic medical records (EMR) on physician time.
• To determine if student note authorship increases documentation burden for residents and attending physicians.

Main Methods:

• Analysis of 46,850 progress notes and histories/physicals from a pediatric hospital medicine service (Jan 2017-Mar 2023).
• EMR-recorded provider access times quantified note editing duration.
• Linear mixed effects models compared editing times for notes authored by residents, third-year (M3), and fourth-year (M4) medical students.

Main Results:

• Attending physicians' note editing time did not significantly differ for notes from residents, M3, or M4 students (approx. 9 minutes).
• Residents spent significantly less time editing M3 student notes (17.3 minutes) compared to authoring their own notes (40.2 minutes).

Conclusions:

• Integrating medical student documentation does not increase attending physician EMR time.
• Residents editing student notes suggests potential efficiency benefits.
• Student documentation is a sustainable educational practice that boosts engagement without increasing physician workload.