Accuracy of Physician Electronic Health Record Usage Analytics using Clinical Test Cases.

Usage log data are an important data source for characterizing the potential burden related to use of the electronic health record (EHR) system. However, the utility of this data source has been hindered by concerns related to the real-world validity and accuracy of the data. While time-motion studies have historically been used to address this concern, the restrictions caused by the pandemic have made it difficult to carry out these studies in-person. In this regard, we introduce a practical approach for conducting validation studies for usage log data in a controlled environment. By developing test runs based on clinical workflows and conducting them within a test EHR environment, it allows for both comparison of the recorded timings and retrospective investigation of any discrepancies. In this case report, we describe the utility of this approach for validating our physician EHR usage logs at a large academic teaching mental health hospital in Canada. A total of 10 test runs were conducted across 3 days to validate 8 EHR usage log metrics, finding differences between recorded measurements and the usage analytics platform ranging from 9 to 60%.

The Impact of the COVID-19 Pandemic on Physician Electronic Health Record Use and Burden at a Canadian Mental Health Hospital.

The COVID-19 Pandemic has significantly changed the delivery of care through new workflows and models of care. However, the impact of these changes on the usage of electronic health record (EHR) systems remains unclear. This mixed method study aims to understand how EHR usage patterns changed between the pandemic onset and the pre-pandemic period at a Canadian mental health hospital, using an analysis of EHR usage log data and a qualitative focus group. An increase in after-hours EHR usage and documentation time per patient was observed, as well as a decrease in order time. Virtual care (VC) use also had an impact on time spent per patient within the EHR and after-hours EHR usage. Qualitative results highlighted physician concerns related to VC workflows and documentation, which contributed to additional EHR burden. Future work should focus on different contexts and developing relevant interventions to address these issues.