Association between state-level malpractice environment and clinician electronic health record (EHR) time
© The Author(s) 2022. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissionsoup.com..
OBJECTIVE: Clinicians spend significant time working in the electronic health record (EHR). The US is an outlier in EHR time, suggesting that EHR-related work may be driven in part by the legal environment and threat of malpractice. To assess this, we evaluate the association between state-level malpractice climate and clinician time spent in the EHR.
MATERIALS AND METHODS: We use EHR metadata from 351 ambulatory care health systems in the United States using Epic from January-August 2019 combined with state-level data on malpractice incidence and payouts. We used descriptive statistics to measure variation in clinician EHR time, including total EHR time, documentation time per day, and after-hours EHR time per day. Multi-variable regression evaluated the association between clinicians in high malpractice states and EHR use.
RESULTS: We found no association between location in a state in the top-quartile of malpractice payouts and time spent in the EHR per day, time spent in the EHR outside of scheduled hours, or time spent documenting per day, except for a subgroup of the clinicians in the highest malpractice specialties, where there was a small increase in EHR time per day (B = 6.08 min, P < 0.001) and time spent documenting notes (B = 2.77 min, P < 0.001).
DISCUSSION: State-level differences in malpractice incidence are unlikely to be a significant driver of EHR work for most clinicians.
CONCLUSION: Policymakers seeking to address EHR documentation burden should examine burden driven by other socio-technical demands on clinician time, such as billing or quality measurement.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Journal of the American Medical Informatics Association : JAMIA - 29(2022), 6 vom: 11. Mai, Seite 1069-1077 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Holmgren, A Jay [VerfasserIn] |
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| Links: |
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| Themen: |
Clinician well-being |
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| Anmerkungen: |
Date Completed 17.05.2022 Date Revised 11.03.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/jamia/ocac034 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM338025685 |
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| 520 | |a © The Author(s) 2022. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a OBJECTIVE: Clinicians spend significant time working in the electronic health record (EHR). The US is an outlier in EHR time, suggesting that EHR-related work may be driven in part by the legal environment and threat of malpractice. To assess this, we evaluate the association between state-level malpractice climate and clinician time spent in the EHR | ||
| 520 | |a MATERIALS AND METHODS: We use EHR metadata from 351 ambulatory care health systems in the United States using Epic from January-August 2019 combined with state-level data on malpractice incidence and payouts. We used descriptive statistics to measure variation in clinician EHR time, including total EHR time, documentation time per day, and after-hours EHR time per day. Multi-variable regression evaluated the association between clinicians in high malpractice states and EHR use | ||
| 520 | |a RESULTS: We found no association between location in a state in the top-quartile of malpractice payouts and time spent in the EHR per day, time spent in the EHR outside of scheduled hours, or time spent documenting per day, except for a subgroup of the clinicians in the highest malpractice specialties, where there was a small increase in EHR time per day (B = 6.08 min, P < 0.001) and time spent documenting notes (B = 2.77 min, P < 0.001) | ||
| 520 | |a DISCUSSION: State-level differences in malpractice incidence are unlikely to be a significant driver of EHR work for most clinicians | ||
| 520 | |a CONCLUSION: Policymakers seeking to address EHR documentation burden should examine burden driven by other socio-technical demands on clinician time, such as billing or quality measurement | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a clinician well-being | |
| 650 | 4 | |a documentation burden | |
| 650 | 4 | |a electronic health records | |
| 650 | 4 | |a medical malpractice | |
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| 700 | 1 | |a Downing, Norman Lance |e verfasserin |4 aut | |
| 700 | 1 | |a Bates, David W |e verfasserin |4 aut | |
| 700 | 1 | |a Schulman, Kevin |e verfasserin |4 aut | |
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