Standardizing metrics for EHR log data could help combat clinician burnout

Better assessment of how often docs interact with their EHRs, at work and during "pajama time" – tracking documentation, prescriptions, inbox time and more, is a key step toward improving the physician experience says one AMA expert.
By Nathan Eddy
12:35 PM

While electronic health record log data has shown promise in measuring the time medical professionals spend on various clinical activities, variations in definitions and methodologies are preventing effective cross-study of that information.

These were among the results of a new study published in the Journal of the American Medical Informatics Association, which also proposed a series of core EHR use measures, and explored the challenges and limitations of such a system.

WHY IT MATTERS
The research was led by Dr. Christine Sinsky, vice president of professional satisfaction at the American Medical Association and an expert on physician burnout.

The aim of the study was to provide a framework for creating standard measures, which would allow for better reproducibility and comparison of research studies.

The report notes the use of EHR log data to further understand the clinical environment is a nascent science, and Sinsky proposed standardized metric is comprised of seven core measures for auditing EHR log data, which reflect multiple dimensions of practice efficiency.

Those encompass: 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.

The research also identifies potential use cases for these measures, highlights unresolved methodologic considerations, and addresses future directions for research and use.

In addition, the creation of such metrics could also be of use to EHR vendors, helping to inform understanding of efficient practices and improve future design, according to the report.

THE LARGER TREND
With physicians already dealing with mountains of data on a daily basis, there is concern EHRs will not be fully useful unless additional technology that turns the data into actionable clinical information at the point of care also is implemented.

A Mayo Clinic study from November 2019 also linked EHR usability with clinician burnout, with the usability of current EHR systems receiving a grade of F by physician users, when evaluated using a standardized metric of technology usability.

A July 2019 study in Health Affairs, meanwhile, found that EHR messaging improvements could be key to reducing physician burnout, and concluded health systems should "reconsider whether system-generated automatic messages are the best way to ensure quality of care."

ON THE RECORD
"While we expect EHR use measures will need to adapt over time in response to advances in technology, changing clinician roles, and evolving regulatory policies, these measures provide a starting point to enhance consistency and reproducibility for analyses of current systems," the report concluded. "Improving the physician experience should, in turn, positively impact the patient experience as well."

Nathan Eddy is a healthcare and technology freelancer based in Berlin.
Email the writer: nathaneddy@gmail.com
Twitter: @dropdeaded209