Summary
Objective: To determine comfort when using the Electronic Health Record (EHR) and increase in
documentation efficiency after an educational intervention for physicians to improve
their transition to a new EHR.
Methods: This study was a single-center randomized, parallel, non-blinded controlled trial
of real-time, focused educational interventions by physician peers in addition to
usual training in the intervention arm compared with usual training in the control
arm. Participants were 44 internal medicine physi cians and residents stratified to
groups using a survey of comfort with electronic media during rollout of a system-wide
EHR and order entry system. Outcomes were median time to complete a progress note,
notes completed after shift, and comfort with EHR at 20 and 40 shifts.
Results: In the intervention group, 73 education sessions averaging 14.4 (SD: 7.7) minutes
were completed with intervention group participants, who received an average of 3.47
(SD: 2.1) interventions. Intervention group participants decreased their time to complete
a progress note more quickly than controls over 30 shifts (p < 0.001) and recorded
significantly fewer progress notes after scheduled duty hours (77 versus 292, p <
0.001). Comfort with EHRs increased significantly in both groups from baseline but
did not differ significantly by group. Intervention group participants felt that the
intervention was more helpful than their standard training (3.47 versus 1.95 on 4-point
scale).
Conclusion: Physicians teaching physicians during clinical work improved physician efficiency
but not comfort with EHRs. More study is needed to determine best methods to assist
those most challenged with new EHR rollouts.
Keywords
Electronic Health Records/utilization - education - physicians
