Abstract

Objectives

The purpose of the study was to determine if association exists between evidence-based provider training and clinician proficiency in electronic health record (EHR) use and if so, which EHR use metrics and vendor-defined indices exhibited association.

Materials and Methods

We studied ambulatory clinicians’ EHR use data published in the Epic Systems Signal report to assess proficiency between training participants (n = 133) and nonparticipants (n = 14). Data were collected in May 2019 and November 2019 on nonsurgeon clinicians from 6 primary care, 7 urgent care, and 27 specialty care clinics. EHR use training occurred from August 5 to August 15, 2019, prior to EHR upgrade and organizational instance alignment. Analytics performed were descriptive statistics, paired t-tests, multivariate correlations, and hierarchal multiple regression.

Results

For number of appointments per 30-day reporting period, trained clinicians sustained an average increase of 16 appointments (P < .05), whereas nontrained clinicians incurred a decrease of 8 appointments. Only the trained clinician group achieved postevent improvement in the vendor-defined Proficiency score with an effect size characterized as moderate to large (d_Cohen = 0.625)

Discussion

Controversies exist on the return of investment from formal EHR training for clinician users. Previously published literature has mostly focused on qualitative data indicators of EHR training success. The findings of our EHR use training study identified EHR use metrics and vendor-defined indices with the capacity for translation into productivity and generated revenue measurements.

Conclusions

One EHR use metric and 1 vendor-defined index indicated improved proficiency among trained clinicians.

中文翻译：

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循证培训与临床医生在电子健康记录使用方面的熟练程度之间的关联

摘要

目标

该研究的目的是确定基于证据的提供者培训与临床医生在电子健康记录 (EHR) 使用方面的熟练程度之间是否存在关联，如果存在关联，则哪些 EHR 使用指标和供应商定义的指数表现出关联。

材料和方法

我们研究了 Epic Systems Signal 报告中发布的门诊临床医生的 EHR 使用数据，以评估培训参与者 (n = 133) 和非参与者 (n = 14) 之间的熟练程度。2019 年 5 月和 2019 年 11 月收集了来自 6 个初级保健、7 个紧急保健和 27 个专科保健诊所的非外科医生临床医生的数据。EHR 使用培训发生在 2019 年 8 月 5 日至 8 月 15 日，在 EHR 升级和组织实例对齐之前。进行的分析是描述性统计、配对 t 检验、多变量相关性和分层多元回归。

结果

对于每 30 天报告期的预约次数，经过培训的临床医生平均增加了 16 次预约（P < .05），而未经培训的临床医生减少了 8 次预约。只有经过培训的临床医生组在供应商定义的熟练程度评分方面取得了事后改善，其影响大小为中到大（d _Cohen = 0.625）

讨论

对临床医生用户的正式 EHR 培训的投资回报存在争议。以前发表的文献主要集中在 EHR 培训成功的定性数据指标上。我们的 EHR 使用培训研究的结果确定了 EHR 使用指标和供应商定义的指数，它们能够转化为生产力和产生的收入测量。

结论

一项 EHR 使用指标和一项供应商定义的指数表明经过培训的临床医生的熟练程度有所提高。