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Topics
- Burnout (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 10 of 10 Research Studies DisplayedKandaswamy S, Pruitt Z, Kazi S
Clinician perceptions on the use of free-text communication orders.
The aim of this study was to investigate (1) why ordering clinicians use free-text orders to communicate medication information; (2) what risks physicians and nurses perceive when free-text orders are used for communicating medication information; and (3) how electronic health records (EHRs) could be improved to encourage the safe communication of medication information. The investigators concluded that clinicians' use of free-text orders as a workaround to insufficient structured order entry can create unintended patient safety risks.
AHRQ-funded; HS025136; HS024755.
Citation: Kandaswamy S, Pruitt Z, Kazi S .
Clinician perceptions on the use of free-text communication orders.
Appl Clin Inform 2021 May;12(3):484-94. doi: 10.1055/s-0041-1731002..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Electronic Health Records (EHRs), Medication: Safety, Medication, Patient Safety, Communication, Provider: Clinician, Provider, Risk
Dymek C, Kim B, Melton GB
AHRQ Author: Dymek C, Hsiao CJ
Building the evidence-base to reduce electronic health record-related clinician burden.
This paper looks at the evidence-base to reduce electronic health record-related (EHR-related) clinician burden. Evidence-based informatics approaches, pragmatic next steps, and future research directions are presented to improve three of the highest contributors to EHR burden: documentation, chart review, and inbox tasks. Perspectives are also offered on how EHR vendors, healthcare system leaders, and policymakers can play an integral role to make EHR easier to use.
AHRQ-authored; AHRQ-funded; HS027363.
Citation: Dymek C, Kim B, Melton GB .
Building the evidence-base to reduce electronic health record-related clinician burden.
J Am Med Inform Assoc 2021 Apr 23;28(5):1057-61. doi: 10.1093/jamia/ocaa238..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Burnout, Evidence-Based Practice, Provider: Clinician, Provider: Physician, Provider
Everson J, Cheng AK, Patrick SW
Association of electronic prescribing of controlled substances with opioid prescribing rates.
The purpose of this study was to assess the association between use of electronic prescribing of controlled substances (EPCS) and trends in opioid prescribing. Results suggested that an increased use of EPCS was not associated with decreased opioid prescribing or a decrease in the amount prescribed and may have been associated with a small increase in opioid prescribing. Recommendations included levers to ensure that EPCS is integrated with outside data and that information is actively used to inform prescribing decisions.
AHRQ-funded; HS026395.
Citation: Everson J, Cheng AK, Patrick SW .
Association of electronic prescribing of controlled substances with opioid prescribing rates.
JAMA Netw Open 2020 Dec;3(12):e2027951. doi: 10.1001/jamanetworkopen.2020.27951..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Opioids, Medication, Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Adler-Milstein J, Zhao W, Willard-Grace R
Electronic health records and burnout: time spent on the electronic health record after hours and message volume associated with exhaustion but not with cynicism among primary care clinicians
This study examined whether objective measures of electronic health record (EHR) use-related to time, volume of work, and proficiency are associated with either exhaustion or cynicism. The authors combined Maslach Burnout Inventory survey measures with objective, vendor-defined EHR use measures from log files. Data was collected from all primary care clinics of a large, urban medical academic center in early 2018. One-third of clinicians had high cynicism and 51% had high emotional exhaustion. The clinicians with the most exhaustion spent time using the EHR after hours.
AHRQ-funded; HS022241.
Citation: Adler-Milstein J, Zhao W, Willard-Grace R .
Electronic health records and burnout: time spent on the electronic health record after hours and message volume associated with exhaustion but not with cynicism among primary care clinicians
J Am Med Inform Assoc 2020 Apr;27(4):531-38. doi: 10.1093/jamia/ocz220..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Burnout, Provider: Clinician, Provider: Physician, Provider, Primary Care
Gomes KM, Ratwani RM
Evaluating improvements and shortcomings in clinician satisfaction with electronic health record usability.
In this research letter, the authors studied usability of electronic health records (EHR) with the system usability scale (SUS). They found that SUS scores decreased for 44% of vendors. Clinician satisfaction with EHR usability is not improving for many widely used products, and the authors recommended increased focus on clinician end users during product design and development as well as optimized certification requirements in order to improve usability.
AHRQ-funded; HS025136.
Citation: Gomes KM, Ratwani RM .
Evaluating improvements and shortcomings in clinician satisfaction with electronic health record usability.
JAMA Netw Open 2019 Dec 2;2(12):e1916651. doi: 10.1001/jamanetworkopen.2019.16651..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Clinician, Provider: Physician, Provider
Southern WN, Applebaum JR, Salmasian H
Clinician experience of electronic health record configurations displaying 1 vs 4 records at a time.
Most electronic health record (EHR) systems have the capability to display more than 1 patient record at a time; however, there is wide variation in practice. In this study, the investigators looked at clinician satisfaction of EHR configuration with varying numbers of records displayed.
AHRQ-funded; HS026121.
Citation: Southern WN, Applebaum JR, Salmasian H .
Clinician experience of electronic health record configurations displaying 1 vs 4 records at a time.
JAMA Intern Med 2019 Dec;179(12):1723-25. doi: 10.1001/jamainternmed.2019.3688..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Clinician, Provider
Zikmund-Fisher BJ, Solomon JB, Scherer AM
Primary care providers' preferences and concerns regarding specific visual displays for returning hemoglobin A1c test results to patients.
Patient portals of electronic health record systems currently present patients with tables of laboratory test results, but visual displays can increase patient understanding and sensitivity to result variations. In this study, the investigators sought to assess physician preferences and concerns about visual display designs as potential motivators or barriers to their implementation.
Citation: Zikmund-Fisher BJ, Solomon JB, Scherer AM .
Primary care providers' preferences and concerns regarding specific visual displays for returning hemoglobin A1c test results to patients.
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Keywords: Primary Care, Electronic Health Records (EHRs), Education: Patient and Caregiver, Health Information Technology (HIT), Provider: Clinician, Provider: Physician, Provider
Patel MR, Friese CR, Mendelsohn-Victor K
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
This study examined the effects of electronic health records (EHRs) on communication and patient safety in oncology practices. The authors conducted a survey of 297 oncology nurses and prescribers in a statewide collaborative. They found there was an inverse relationship between reliance on EHRs and safety.
AHRQ-funded; HS024914.
Citation: Patel MR, Friese CR, Mendelsohn-Victor K .
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
J Oncol Pract 2019 Jun;15(6):e529-e36. doi: 10.1200/jop.18.00507..
Keywords: Cancer, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider, Provider: Clinician
P Dellsperger, KC Fallaw, D
AHRQ Author: Rangachari
A mixed-method study of practitioners' perspectives on issues related to EHR medication reconciliation at a health system.
This study sought to identify issues related to electronic health record (EHR) medication reconciliation (MedRec) from the perspective of practitioners directly involved in the EHR MedRec process, with the goal of reducing medication discrepancies during transitions of care and improving the accuracy of patient medication lists. The study was conducted in two rounds: individual interviews, then a survey of physicians, nurses, and pharmacists based in the outpatient and inpatient medicine service at AU Health. The survey elicited practitioner ratings of the importance of issues identified during the interviews. Issues that were rated as important by more than 70 percent of respondents include care coordination, patient education, ownership and accountability, processes-of-care, IT-related issues, and workforce training. From these issues, the authors conclude that there is an absence of shared understanding among practitioners regarding the value of EHR MedRec in promoting patient safety, which contributes to work-arounds and the suboptimal use of the EHR MedRec system, and there is also a sociotechnical dimension to many of these issues which creates an additional layer of complexity.
AHRQ-funded; HS024335.
Citation: P Dellsperger, KC Fallaw, D .
A mixed-method study of practitioners' perspectives on issues related to EHR medication reconciliation at a health system.
Qual Manag Health Care 2019 Apr/Jun;28(2):84-95. doi: 10.1097/qmh.0000000000000208..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Medication: Safety, Patient Safety, Provider, Provider: Clinician
Revere D, Hills RH, Dixon BE
Notifiable condition reporting practices: implications for public health agency participation in a health information exchange.
The researchers sought to better understand the barriers to and burden of notifiable condition reporting from the perspectives of clinic physicians, interviews with clinic reporters, and interviews with public health workers involved in reporting workflow. A strong recommendation generated by their findings is that, given their central role in reporting, clinic reporters are a significant target audience for public health outreach and education that aims to alleviate perceived reporting burden and improve reporting knowledge.
AHRQ-funded; HS020909.
Citation: Revere D, Hills RH, Dixon BE .
Notifiable condition reporting practices: implications for public health agency participation in a health information exchange.
BMC Public Health 2017 Mar 11;17(1):247. doi: 10.1186/s12889-017-4156-4.
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Keywords: Health Information Exchange (HIE), Public Health, Infectious Diseases, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Physician, Provider: Clinician, Provider