A study published this week in the Journal of the American Medical Informatics Association sought to examine the relationship between electronic health record proficiency tools and time spent interacting with the EHR.  

Researchers found that only one proficiency tool was associated with reduced time spent in the EHR.

However, they also found that primary care physicians who had greater support from their care team in writing notes spent less time in documentation-specific activities and less total time in the record per day.  

"These findings suggest that PCPs may experience reductions in EHR-related burden and documentation burden by decentralizing documentation responsibilities," wrote the research team.  

WHY IT MATTERS

Given EHRs' potential role in clinician burnout, researchers are increasingly turning their attention to factors that may increase (or decrease) time burden.   

In the JAMIA study, the researchers sought to investigate whether reduced time in the Epic EHR was associated with several proficiency tools and behaviors, including QuickActions, NoteSpeed buttons, NoteWriter macros, QuickFilters and SmartPhrases.  

Surprisingly, many of the proficiency behaviors were associated with more time in the EHR – namely, QuickActions and SmartPhrases.  

Only NoteSpeed buttons were associated with reduced EHR time.  

"The findings could indicate that PCPs who spent more time in the EHR may be more likely to use these EHR features as well as create longer notes," observed the researchers.   

"Indeed, prior studies found the use of documentation tools … were associated with longer notes," they added. "Alternatively, the findings may suggest that such features may only be truly useful for limited types of clinical encounters."  

Meanwhile, the study did find that team-based documentation models could reduce EHR-related burdens for PCPs. Organizations could implement such models by using nursing staff, medical assistants, medical students or scribing programs.  

"Although the care team can offload some documentation burden from physicians, healthcare organizations could amplify these benefits by enabling patients to assist in documentation tasks," observed the researchers.  

They also pointed to potential training opportunities for EHR workflows, especially as interfaces are updated.  

"Clinicians may benefit from practicing new EHR skills in a training environment as scenario-based training and simulations have been shown to improve educational outcomes with EHR use," they wrote.  

THE LARGER TREND

Several studies have sought to examine the relationship between EHRs and clinician burnout, pointing to usability, message volume and patient-generated data as potential culprits.  

But EHRs aren't always to blame. Recent research shows that chaotic workplaces, after-hours workloads and bureaucratic tasks are major contributing factors to burnout – and COVID-19 has only made matters worse.  

ON THE RECORD  

"The present results … highlight the need for future qualitative research on the reasons for use or non-use of documentation support tools, as different interventions may be required based on the predominant reasons discovered," read the JAMIA study.  

"These studies could also identify types of clinical encounters when certain tools may be more useful," it continued.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.