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Randomized Controlled Trial
. 2023 Apr 19;30(5):953-957.
doi: 10.1093/jamia/ocad025.

Effect of restricting electronic health records on clinician efficiency: substudy of a randomized clinical trial

Jerard Z Kneifati-Hayek  1 , Jo R Applebaum  1 , Clyde B Schechter  2 , Alexis Dal Col  3 , Hojjat Salmasian  4 , William N Southern  5 , Jason S Adelman  1   6
Affiliations
Randomized Controlled Trial

Effect of restricting electronic health records on clinician efficiency: substudy of a randomized clinical trial

Jerard Z Kneifati-Hayek et al. J Am Med Inform Assoc. .

Abstract

A prior randomized controlled trial (RCT) showed no significant difference in wrong-patient errors between clinicians assigned to a restricted electronic health record (EHR) configuration (limiting to 1 record open at a time) versus an unrestricted EHR configuration (allowing up to 4 records open concurrently). However, it is unknown whether an unrestricted EHR configuration is more efficient. This substudy of the RCT compared clinician efficiency between EHR configurations using objective measures. All clinicians who logged onto the EHR during the substudy period were included. The primary outcome measure of efficiency was total active minutes per day. Counts were extracted from audit log data, and mixed-effects negative binomial regression was performed to determine differences between randomized groups. Incidence rate ratios (IRRs) were calculated with 95% confidence intervals (CIs). Among a total of 2556 clinicians, there was no significant difference between unrestricted and restricted groups in total active minutes per day (115.1 vs 113.3 min, respectively; IRR, 0.99; 95% CI, 0.93-1.06), overall or by clinician type and practice area.

Keywords: audit log data; efficiency; electronic health record.

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Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Substudy flow diagram. Randomization and allocation of clinicians in the efficiency substudy.
See this image and copyright information in PMC

References

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