Appl Clin Inform 2022; 13(04): 785-793
DOI: 10.1055/a-1877-2745
Research Article

Physician Electronic Health Record Usage as Affected by the COVID-19 Pandemic

Elise Ruan
1   Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
,
Moshe Beiser
1   Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
,
Vivian Lu
1   Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
,
Soaptarshi Paul
1   Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
,
Jason Ni
1   Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
,
Nijas Nazar
1   Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
,
Jianyou Liu
2   Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States
,
Mimi Kim
2   Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States
,
Eric Epstein
1   Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
,
Marla Keller
1   Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
3   Division of Infectious Disease, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, United States
,
Elizabeth Kitsis
1   Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
4   Division of Rheumatology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, United States
,
Yaron Tomer
1   Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
,
Sunit P. Jariwala
1   Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States
5   Division of Allergy/Immunology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, United States
› Author Affiliations
Funding None.

Abstract

Objectives To utilize metrics from physician action logs to analyze volume, physician efficiency and burden as impacted by telemedicine implementation during the COVID-19 (coronavirus disease 2019) pandemic, and physician characteristics such as gender, years since graduation, and specialty category.

Methods We selected 11 metrics from Epic Signal, a functionality of the Epic electronic health record (EHR). Metrics measuring time spent in the EHR outside working hours were used as a correlate for burden. We performed an analysis of these metrics among active physicians at our institution across three time periods—prepandemic and telehealth implementation (August 2019), postimplementation of telehealth (May 2020), and follow-up (July 2020)—and correlated them with physician characteristics.

Results Analysis of 495 physicians showed that after the start of the pandemic, physicians overall had fewer appointments per day, higher same day visit closure rates, and spent less time writing notes in the EHR outside 7 a.m. to 7 p.m. on patient scheduled days. Across all three time periods, male physicians had better EHR-defined “efficiency” measures and spent less time in the EHR outside working hours. Years since graduation only had modest associations with higher same day visit closure rates and appointments per day in May 2020. Specialty category was significantly associated with appointments per day and same day closure visit rates and also was a significant factor in the observed changes seen across the three time periods.

Conclusion Utilizing EHR-generated reports may provide a scalable and nonintrusive way to monitor trends in physician usage and experience to help guide health systems in increasing productivity and reducing burnout.



Publication History

Received: 02 March 2022

Accepted: 12 June 2022

Accepted Manuscript online:
15 June 2022

Article published online:
25 August 2022

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