Interventions to increase physician efficiency and comfort with an electronic health record system.
OBJECTIVE
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).


CONCLUSIONS
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.
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Anthony A. Donato, MD MHPE, Department of Internal Medicine, Reading Health System, West Reading PA 19612, USA, E-mail: anthony.donato@readinghealth.org.
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D000046:Academic Medical Centers / Q000458:organization & administration; D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003197:Computer Literacy; D004059:Diffusion of Innovation; D004526:Efficiency; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008490:Medical Informatics / Q000193:education; D008505:Medical Staff, Hospital / Q000193:education* / Q000523:psychology; D011795:Surveys and Questionnaires
Electronic Health Records/utilization; education; physicians