Effect of restricting electronic health records on clinician efficiency: substudy of a randomized clinical trial.
Effect of restricting electronic health records on clinician efficiency: substudy of a randomized clinical trial.
复制标题
限制电子健康记录对临床医生效率的影响：随机临床试验的子研究。
DOI：
10.1093/jamia/ocad025
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Adelman,JasonS
中科院分区：
文献类型：
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作者：
Kneifati-Hayek,JerardZ;Applebaum,JoR;Schechter,ClydeB;DalCol,Alexis;Salmasian,Hojjat;Southern,WilliamN;Adelman,JasonS
先前的一项随机对照试验(RCT)显示，分配到受限电子健康记录(EHR)配置(一次限制打开一个记录)和非受限EHR配置(允许同时打开最多4个记录)的临床医生在错误患者错误方面没有显著差异。然而，目前尚不清楚不受限制的EHR配置是否更有效。RCT的这项子研究使用客观测量方法比较了不同EHR配置的临床医生效率。所有在亚研究期间登录EHR的临床医生都被包括在内。衡量效率的主要结果是每天的总活动分钟数。从审计日志数据中提取计数，并进行混合效应负二项回归以确定随机分组之间的差异。发病率比(IRR)以95%可信区间(CI)计算。在2 5 5 6名临床医生中，非限制组和限制组的每日总活动分钟数无显著差异(分别为115.1和113.3分钟；内部收益率0.99；95%可信区间0.93~1.0 6)，总体上或按临床医生类型和执业领域划分。
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.