Metrics for assessing physician activity using electronic health record log data

Author:

Sinsky Christine A1,Rule Adam2ORCID,Cohen Genna3,Arndt Brian G4,Shanafelt Tait D5,Sharp Christopher D56,Baxter Sally L78ORCID,Tai-Seale Ming9,Yan Sherry10,Chen You11,Adler-Milstein Julia12,Hribar Michelle2

Affiliation:

1. Department of Medicine, American Medical Association, Chicago, Illinois, USA

2. Department of Medical Informatics and Clinical Epidemiology, Oregon Health Sciences University, Oregon, USA

3. Department of Medicine, Mathematica, Washington, DC, USA

4. Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA

5. Division of Hematology, Department of Medicine, Stanford University, Stanford, California, USA

6. Division of General Internal Medicine, Department of Medicine, Stanford University, Stanford, California, USA

7. Department of Biomedical Informatics, University of California, San Diego, San Diego, California, USA

8. Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, San Diego, California, USA

9. Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California, USA

10. Department of Medicine, Sutter Health, Walnut Creek, California, USA

11. Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA

12. Department of Medicine, University of California, San Francisco, San Francisco, California, USA

Abstract

Abstract Electronic health record (EHR) log data have shown promise in measuring physician time spent on clinical activities, contributing to deeper understanding and further optimization of the clinical environment. In this article, we propose 7 core measures of EHR use that reflect multiple dimensions of practice efficiency: total EHR time, work outside of work, time on documentation, time on prescriptions, inbox time, teamwork for orders, and an aspirational measure for the amount of undivided attention patients receive from their physicians during an encounter, undivided attention. We also illustrate sample use cases for these measures for multiple stakeholders. Finally, standardization of EHR log data measure specifications, as outlined here, will foster cross-study synthesis and comparative research.

Publisher

Oxford University Press (OUP)

Subject

Health Informatics

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