Methods Inf Med - Interventions to increase physician efficiency and comfort with an electronic health record system.


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JECTIVE: 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 physicians 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.

Resumo Limpo

jectiv determin comfort use electron health record ehr increas document effici educ intervent physician improv transit new ehrmethod studi singlecent random parallel nonblind control trial realtim focus educ intervent physician peer addit usual train intervent arm compar usual train control arm particip intern medicin physician resid stratifi group use survey comfort electron media rollout systemwid ehr order entri system outcom median time complet progress note note complet shift comfort ehr shiftsresult intervent group educ session averag sd minut complet intervent group particip receiv averag sd intervent intervent group particip decreas time complet progress note quick control shift p record signific fewer progress note schedul duti hour versus p comfort ehr increas signific group baselin differ signific group intervent group particip felt intervent help standard train versus point scaleconclus physician teach physician clinic work improv physician effici comfort ehr studi need determin best method assist challeng new ehr rollout

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