在医生减少临床访问量后,初级保健医生电子健康记录模式的变化
Gabe G Weinreb1, A Jay Holmgren2, Nate C Apathy3
1Gabe G. Weinreb (gweinreb@hbs.edu), Harvard University, Boston, Massachusetts.
Health affairs (Project Hope)
|February 2, 2026
概括
初级保健医生减少了病人访问,但仍然花费大量时间在电子健康记录 (EHR) 上. 这种异步的EHR工作增加了每次访问的负担,表明需要工作流创新.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
- 主要护理医学 医疗保健
背景情况:
- 初级保健医生 (PCP) 经历了不断升级的工作负载压力.
- 一个PCP的子集正在减少患者访问量,但对整体工作量的影响仍然不清楚.
研究的目的:
- 调查患者访问量减少与初级保健医生电子健康记录 (EHR) 使用之间的关系.
- 为了分析EHR时间的变化,异步工作和患者组复杂性,在减少访问量后.
主要方法:
- 利用了国家Epic EHR元数据从2019-2022年.
- 对比了减少每月访问量>=10% (减少者) 与没有减少 (非减少者) 的医生的EHR使用和患者特征.
- 分析了访问的变化,每次访问的EHR时间,以及EHR工作后的EHR工作时间.
主要成果:
- 减少访问的医生每月访问量减少了32.6%,但EHR时间仅下降了21.2%.
- 每次访问的EHR分钟在减少者中增加了21.3%.
- 不同步的EHR任务,包括电子收件箱消息和超时EHR工作,每次访问增加.
结论:
- 减少患者访问量并不会相应地减少初级保健中的EHR工作量.
- 异步的EHR任务持续并逐次加剧,突出了对高效的异步护理交付模型的关键需求.
- 创新策略对于管理EHR需求和支持面临工作量压力的初级保健医生至关重要.
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