In the United States, the electronic health record (EHR) has become increasingly prevalent in the day-to-day practice of physicians, with primary care physicians (PCPs) spending the most time in the EHR. Yet, the association between time spent in the EHR and quality of ambulatory care was unclear before Brigham and Women’s researchers investigated this critical intersection. In their cross-sectional study of 291 primary care physicians, the team tracked ambulatory quality measures (year-end, PCP panel-level achievement of targets for hemoglobin A1C level control, lipid management, hypertension control, diabetes screening, and breast cancer screening) and found a significant, positive relationship between EHR time and some of these measures — panel-wide hemoglobin A1C level control, hypertension control, and breast cancer screening. These associations suggest that extra time spent in the EHR may benefit certain care outcomes, particularly for doctors who spend less than half their time seeing patients.
“Although increased EHR time is associated with burnout, it may represent a level of thoroughness or communication that enhances certain outcomes,” said lead author Lisa Rotenstein, MD, MBA, of the Primary Care Center of Excellence at the Brigham. “It may be useful for future studies to characterize payment models, workflows, and technologies that enable high-quality ambulatory care delivery while minimizing EHR burden.”
Read more in JAMA Network Open.
Journal
JAMA Network Open
DOI
10.1001/jamanetworkopen.2022.37086
Method of Research
Observational study
Subject of Research
People
Article Title
Association Between Electronic Health Record Time and Quality of Care Metrics in Primary Care
Article Publication Date
18-Oct-2022
COI Statement
Dr Rotenstein reported receiving grants from the American Medical Association outside the submitted work. Dr Holmgren reported receiving grants the from American Medical Association and Healthcare Leadership Council outside the submitted work. Dr Bates reported receiving fees from EarlySense for consulting and speaking, fees from CDI Negev for consulting, equity from ValeraHealth for consulting, equity from Clew for consulting, equity from MDClone for consulting, equity and personal fees from AESOP, equity and personal fees from Guided Clinical Solutions, and grants from IBM Watson Health outside the submitted work. In addition, Dr Bates had a patent for PHC-028564 US PCT pending Mass General Brigham Intraoperative decision support. No other disclosures were reported.
