Clinician Perceptions of Transition From Legacy Electronic Health Record to MHS GENESIS: A Pilot Study.

INTRODUCTION: The implementation of a new electronic health record (EHR) presents significant challenges as users navigate a new interface. Our institution was an early adopter of MHS GENESIS (MHSG), the MHS's new EHR. This study investigated provider perceptions of usability and the prevalence of burnout during an EHR transition from the Legacy system (LEHR) utilizing online, anonymous surveys before implementation and at several points post-implementation. MATERIALS AND METHODS: Clinician satisfaction, perceptions of EHR impact on safety, communication, reliability, and chart completion were assessed on five-point Likert scales. Usability was assessed using the validated System Usability Scale (SUS). Burnout prevalence was assessed using a validated single-item measure. Data were gathered via online, anonymous surveys before implementation and at 1, 3-6, and 9-12 months post "Go-Live." RESULTS: Of 367 clinicians, 56 responded to the baseline survey; on average, 29% of responses were positive (i.e., satisfied or very satisfied) with LEHR. Following implementation, an average of 47%, 37%, and 47% of responses were positive for MHSG at 1 months (n = 42), 6 months (n = 55), and 12 months (n = 30), respectively. The mean SUS for LEHR was 48 (on a scale of 1-100); for MHSG, the mean SUS was 48 (1 month), 41 (6 months), and 44 (12 months). The burnout rate was reported as 39% (baseline), 26% (1 month), 33% (6 months), and 37% (12 months). CONCLUSIONS: Perceptions of system usability, physician satisfaction, and burnout were not remarkably different between the two systems. Study results imply a need for further investigation as to why most clinicians continue to be unsatisfied with MHSG and wish to return to LEHR and whether or how this EHR transition contributed to burnout or if other factors are more contributory in this population. Future studies could also explore whether changes in the clinician interface, training, or implementation process impact clinician satisfaction, burnout, and desire to return to LEHR, or if these measures change with longer follow-up or in more varied populations.

Writing Rounds: An Innovation to Increase Physician Scientific Dissemination.

INTRODUCTION: Many high-quality studies presented at conferences never reach the peer-reviewed literature, most likely because physician authors do not take the next step to fully write up the studies and submit them to a journal. We evaluated a curriculum designed to equip authors with the practical skills to submit research projects to peer-reviewed publication. METHODS: We designed a mixed asynchronous-synchronous longitudinal curriculum, occurring across 4 months via a virtual platform. To evaluate the curriculum, we tracked process and production outcomes and conducted semistructured interviews with participants following participation. RESULTS: Across two cohorts in 2019, nine participant authors completed the curriculum. Seven participants submitted their studies for publication; two were accepted. In interviews with eight participants, participant authors described the value of the program, expressing intention to participate again and to recommend it to colleagues. CONCLUSION: Through a coach-directed writing group, participant authors developed the skills and confidence needed to prepare and submit scientific manuscripts for peer review. Curriculum maintenance and enhancement is ongoing. We plan to scale up this innovation in support of other university departments and medical disciplines, developing an implementation guide to describe needed elements, including technological platforms, qualities of the coach, author recruitment, and group conduct.

Plan-Do-Study-Act Cycles Applied to a Longitudinal Research Protocol in a Family Medicine Residency.

BACKGROUND AND OBJECTIVES: Barriers to research in family medicine are common. Resident studies are at risk of remaining incomplete. This report describes a process improvement (PI) to optimize survey data collection in a longitudinal research protocol led by family medicine residents. The protocol subject to the process improvement sought to evaluate maternal outcomes in group prenatal care vs traditional care. In the months preceding the PI, the resident researchers noted many surveys were not completed in their intended timeframe or were missing, threatening study validity. We describe a practical case example of the use of a PI tool to resident-led research. METHODS: The residents applied three plan-do-study-act (PDSA) cycles over 8 months. Throughout the cycles, we solicited barriers and proposed solutions from the research team. Process measures included percentage of surveys completed within 2 weeks of the deadline ("on-time" response rate), and percentage of surveys completed overall. RESULTS: A secure, shared survey tracker was created and optimized during three PDSA cycles to calculate and track survey deadlines automatically upon enrollment in the study. Automated colored flags appeared for due or overdue surveys. On-time response rates did not improve. Overall response rates did improve meaningfully from 57% (19 of 33 eligible) to 84% (16 of 19 eligible). CONCLUSIONS: The PDSA cycles improved survey response rates in this research protocol. This intervention incurred no cost, was easily implemented, and was impactful. Other research teams can apply this PI tool to barriers in their research processes with minimal risk and cost.