TY - JOUR
T1 - The implementation of a multidisciplinary, electronic health record embedded care pathway to improve structured data recording and decrease electronic health record burden
AU - Ebbers, Tom
AU - Takes, Robert P.
AU - Smeele, Ludi E.
AU - Kool, Rudolf B.
AU - van den Broek, Guido B.
AU - Dirven, Richard
N1 - Publisher Copyright: © 2024 The Author(s)
PY - 2024/4/1
Y1 - 2024/4/1
N2 - Introduction: Theoretically, the added value of electronic health records (EHRs) is extensive. Reusable data capture in EHRs could lead to major improvements in quality measurement, scientific research, and decision support. To achieve these goals, structured and standardized recording of healthcare data is a prerequisite. However, time spent on EHRs by physicians is already high. This study evaluated the effect of implementing an EHR embedded care pathway with structured data recording on the EHR burden of physicians. Materials and methods: Before and six months after implementation, consultations were recorded and analyzed with video-analytic software. Main outcome measures were time spent on specific tasks within the EHR, total consultation duration, and usability indicators such as required mouse clicks and keystrokes. Additionally, a validated questionnaire was completed twice to evaluate changes in physician perception of EHR system factors and documentation process factors. Results: Total EHR time in initial oncology consultations was significantly reduced by 3.7 min, a 27 % decrease. In contrast, although a decrease of 13 % in consultation duration was observed, no significant effect on EHR time was found in follow-up consultations. Additionally, perceptions of physicians regarding the EHR and documentation improved significantly. Discussion: Our results have shown that it is possible to achieve structured data capture while simultaneously reducing the EHR burden, which is a decisive factor in end-user acceptance of documentation systems. Proper alignment of structured documentation with workflows is critical for success. Conclusion: Implementing an EHR embedded care pathway with structured documentation led to decreased EHR burden.
AB - Introduction: Theoretically, the added value of electronic health records (EHRs) is extensive. Reusable data capture in EHRs could lead to major improvements in quality measurement, scientific research, and decision support. To achieve these goals, structured and standardized recording of healthcare data is a prerequisite. However, time spent on EHRs by physicians is already high. This study evaluated the effect of implementing an EHR embedded care pathway with structured data recording on the EHR burden of physicians. Materials and methods: Before and six months after implementation, consultations were recorded and analyzed with video-analytic software. Main outcome measures were time spent on specific tasks within the EHR, total consultation duration, and usability indicators such as required mouse clicks and keystrokes. Additionally, a validated questionnaire was completed twice to evaluate changes in physician perception of EHR system factors and documentation process factors. Results: Total EHR time in initial oncology consultations was significantly reduced by 3.7 min, a 27 % decrease. In contrast, although a decrease of 13 % in consultation duration was observed, no significant effect on EHR time was found in follow-up consultations. Additionally, perceptions of physicians regarding the EHR and documentation improved significantly. Discussion: Our results have shown that it is possible to achieve structured data capture while simultaneously reducing the EHR burden, which is a decisive factor in end-user acceptance of documentation systems. Proper alignment of structured documentation with workflows is critical for success. Conclusion: Implementing an EHR embedded care pathway with structured documentation led to decreased EHR burden.
KW - Care pathways
KW - Documentation burden
KW - E-pathways
KW - Electronic health record
KW - Structured data recording
UR - http://www.scopus.com/inward/record.url?scp=85183971842&partnerID=8YFLogxK
U2 - 10.1016/j.ijmedinf.2024.105344
DO - 10.1016/j.ijmedinf.2024.105344
M3 - Article
C2 - 38310755
SN - 1386-5056
VL - 184
JO - International Journal of Medical Informatics
JF - International Journal of Medical Informatics
M1 - 105344
ER -