在退伍军人卫生管理局的初级保健临床医生中使用虚拟观测的电子健康记录时间分配
Stefanie A Deeds1,2, Scott L Hagan1,2, Sara E Kath1
1VA Puget Sound Health Care System, Seattle, WA, USA.
Journal of general internal medicine
|January 6, 2025
概括
退伍军人卫生管理局的初级保健提供者在电子健康记录 (EHR) 上花费了35-46%的访问时间. 虚拟访问需要更多的EHR时间,而不是面对面的访问,患者之间需要大量的行政工作.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床信息学 临床信息学
- 主要护理医学 医疗保健
背景情况:
- 之前的研究表明,初级保健临床医生 (PCP) 在访问患者期间花费大量时间处理电子健康记录 (EHR) 任务.
- 关于退伍军人卫生管理局 (VHA) 内部的EHR时间分配,特别是虚拟护理模式期间的数据有限.
- 了解EHR时间对于优化临床医生的工作流程和患者护理效率至关重要.
研究的目的:
- 量化PCP在VHA设施的初级保健接触期间与EHR互动的时间比例.
- 为了比较个人和虚拟 (电话,视频) 初级保健访问之间的EHR时间分配.
- 评估PCP在患者预约之间花在EHR行政任务上的时间.
主要方法:
- 使用适应的软件 (WorkStudy+) 进行了时间运动研究,用于远程观察.
- 从VHA三个区域站点的23名PCP (医生和护士执业人员) 收集数据.
- 观察到的指标包括访问的持续时间和在访问期间和访问之间用于EHR任务的百分比时间.
主要成果:
- 在211次观察访问中,平均持续时间为23.9分钟 (面对面),21.2分钟 (电话) 和29.3分钟 (视频).
- 在面对面的访问时间中,EHR工作占35%,在电话访问中占46%,在视频访问中占39%.
- 在访问之间,PCP每次4小时的会议花费54分钟的行政任务,主要是文档 (44%) 和图表审查 (14%).
结论:
- VHA的PCP将35%至46%的患者访问时间分配给EHR任务,主要是文档和图表审查.
- 虚拟访问与面对面访问相比,需要更多的EHR交互时间,这表明当患者在实体上存在时,EHR的使用减少了.
- PCP每半天的临床会议花费超过两个小时在EHR任务上,包括在患者之间执行的行政工作.
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