Changes in Physician Electronic Health Record Use With the Expansion of Telemedicine

作者：A Jay Holmgren, Robert L. Thombley, Christine A. Sinsky, Julia Adler‐Milstein · 发表于：JAMA Internal Medicine · 年份：2023 · DOI：10.1001/jamainternmed.2023.5738 · 被引用次数：44 · 研究领域：Telemedicine and Telehealth Implementation、Mobile Health and mHealth Applications、Electronic Health Records Systems

Importance: Understanding the drivers of electronic health record (EHR) burden, including EHR time and patient messaging, may directly inform strategies to address physician burnout. Given the COVID-19-induced expansion of telemedicine-now used for a substantial proportion of ambulatory encounters-its association with EHR burden should be evaluated. Objective: To measure the association of the telemedicine expansion with time spent working in the EHR and with patient messaging among ambulatory physicians before and after the onset of the COVID-19 pandemic. Design, Setting, and Participants: This longitudinal cohort study analyzed weekly EHR metadata of ambulatory physicians at UCSF Health, a large academic medical center. The same EHR measures were compared for 1 year before the COVID-19 pandemic (August 2018-September 2019) with the same period 1 year after its onset (August 2020-September 2021). Multivariable regression models evaluating the association between level of telemedicine use and EHR use were then assessed after the onset of the pandemic. The sample included all physician-weeks with at least 1 scheduled half-day clinic in the 11 largest ambulatory specialties at UCSF Health. Data analyses were performed from March 1, 2022, through July 1, 2023. Exposures: Physicians' weekly modality mix of either entirely face-to-face visits, mixed modalities, or entirely telemedicine. Main Outcomes and Measures: The EHR time during and outside of patient scheduled hours (PSHs), ...