Have you got the time? Challenges using vendor electronic health record metrics of provider efficiency

Abstract

The rise of clinician burnout has been correlated with the increased adoption of electronic health records (EHRs). Some vendors have used data entry logs to measure the amount of time spent using the EHR and have developed metrics of provider efficiency. Initial attempts to utilize these data have proven difficult as it is not always apparent whether variations reflect provider behavior or simply the metric definitions. Metric definitions are also updated intermittently without warning, making longitudinal assessment problematic. Because the metrics are based on proprietary algorithms, they are impossible to validate without costly time-motion studies and are also difficult to compare across institutions and vendors. Clinical informaticians must partner with vendors in order to develop industry standards of EHR use, which could then be used to examine the impact of EHRs on clinician burnout.

Keywords: Electronic health record; physician burnout; provider efficiency.

Figure 1.

Comparison of 2 vendors’ reporting time in the electronic health record per patient seen. Panels A1 and A2 use data from 1 vendor to compare time spent in the EHR per patient in 2 ambulatory clinics, stratified by the EHR activity. Panels B1 and B2 use data from another vendor at a different institution and compare time spent in chart review and documentation per patient for 2 inpatient services.