Individual physician‐to‐physician tutoring with learners in their real environment during rollouts of new electronic health records (EHRs) can identify specific barriers and provide opportunities for ‘just in time’ educational interventions that may improve physician acceptance and efficiency.
Randomized, controlled trial of inpatient general medicine physicians stratified by level of computer usage, allocated to groups in 1:1 pairings during an EHR rollout. Controls received usual training with non‐ physician technical support. The intervention group received this and received impromptu physician‐led direct observation‐generated tips while practicing in their work environment as well as weekly electronic reports of best practices.
Satisfaction and comfort with electronic record systems after 20 and 40 shifts post‐rollout.
Number of smart tools used, time of completion of last note relative to the end of shift, total time to complete note.
Balancing measures: Satisfaction with their randomization group
Intervention doctors averaged 2.0 interventions for a total average contact time of 50.4 ± 7.1 minutes, (average of 5‐ 45 min/intervention). Total cost of intervention was $2,775 (18.5 hours x $150/hour). Comfort with electronic systems increased with use (control, 2.0 to 3.2 at 40 weeks, intervention 2.1 to 3.4 at 40 weeks on a 4‐point likert scale, p= 0.36). After the first 40 weeks, time to complete a progress note was similar (control: 11.8 minutes, intervention: 9.7 minutes, p=0.21), note completion relative to end shift was similar (control, +97.3 minutes, intervention +43.3 minutes, p= 0.22) and average satisfaction with randomization group were similar at 40 weeks (control: 3.50, ntervention: 3.41 on 4‐point Likert, p=0.48).
No difference in physician comfort and speed was seen in these short, non‐directed teaching efforts. Whether this strategy performed by non‐EHR novice teachers and directed to those in most need is a matter for further study.
To cite this abstract:Jalota L, Aryal M, Mahmood M, Motz L, Donato A, Mainali N. Interventions to Increase Physician Effectiveness and Acceptance of a New Electronic Order Entry and Electronic Medical Record System. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 113. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/interventions-to-increase-physician-effectiveness-and-acceptance-of-a-new-electronic-order-entry-and-electronic-medical-record-system/. Accessed March 20, 2019.