ArticleJournal of the American Medical Informatics Association : JAMIA
How is the electronic health record being used? Use of EHR data to assess physician-level variability in technology use.
Article in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
47 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Using electronic health record audit logs to study clinical activity: a systematic review of aims, measures, and methods.Journal of the American Medical Informatics Association : JAMIA · 2020Pooled it
- Barriers and Facilitators to the Use of Clinical Decision Support Systems in Primary Care: A Mixed-Methods Systematic Review.Annals of family medicinePooled it
- Effect of an Electronic Health Record "Nudge" on Opioid Prescribing and Electronic Health Record Keystrokes in Ambulatory Care.Journal of general internal medicine · 2021Trial
- Association between electronic health records and health care utilization.Applied clinical informatics · 2015Trial
- Development and Evaluation of Clinical Decision Support for Immigrant Child Health Screening in Primary Care.Applied clinical informatics · 2025Article
- Electronic health record activity changes around new decision support implementation: monitoring using audit logs and topic modeling.JAMIA open · 2025Article
- The Elements of Style for Interruptive Electronic Health Record Alerts.Applied clinical informatics · 2025Article
- Relationships Among Physician Vendor-Derived Proficiency Score, Gender, and Time in the Electronic Health Record.Family medicine · 2025Observational
- Clinical encounter heterogeneity and methods for resolving in networked EHR data: a study from N3C and RECOVER programs.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Distinct components of alert fatigue in physicians' responses to a noninterruptive clinical decision support alert.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Inaccurate recording of routinely collected data items influences identification of COVID-19 patients.International journal of medical informatics · 2022Article
- Opioid and Naloxone Prescribing Following Insertion of Prompts in the Electronic Health Record to Encourage Compliance With California State Opioid Law.JAMA network open · 2022Article
- Impact of a medical scribe on clinical efficiency and quality in an academic general internal medicine practice.BMC health services research · 2021Article
- Incidence of opioid use disorder in the year after discharge from an emergency department encounter.Journal of the American College of Emergency Physicians open · 2021Article
- Conceptual considerations for using EHR-based activity logs to measure clinician burnout and its effects.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Defining Data Migration Across Multidisciplinary Ambulatory Clinics Using Participatory Design.Applied clinical informatics · 2021Review
- Association Between Proficiency and Efficiency in Electronic Health Records Among Pediatricians at a Major Academic Health System.Frontiers in digital health · 2021Article
- Article
- An Interdisciplinary Approach to Reducing Errors in Extracted Electronic Health Record Data for Research.Perspectives in health information managemen · 2021Article
- Challenges involved in establishing a web-based clinical decision support tool in community health centers.Healthcare (Amsterdam, Netherlands) · 2020Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStudies of the effects of electronic health records (EHRs) have had mixed findings, which may be attributable to unmeasured confounders such as individual variability in use of EHR features.
objectiveTo capture physician-level variations in use of EHR features, associations with other predictors, and usage intensity over time.
methodsRetrospective cohort study of primary care providers eligible for meaningful use at a network of federally qualified health centers, using commercial EHR data from January 2010 through June 2013, a period during which the organization was preparing for and in the early stages of meaningful use.
resultsData were analyzed for 112 physicians and nurse practitioners, consisting of 430,803 encounters with 99,649 patients. EHR usage metrics were developed to capture how providers accessed and added to patient data (eg, problem list updates), used clinical decision support (eg, responses to alerts), communicated (eg, printing after-visit summaries), and used panel management options (eg, viewed panel reports). Provider-level variability was high: for example, the annual average proportion of encounters with problem lists updated ranged from 5% to 60% per provider. Some metrics were associated with provider, patient, or encounter characteristics. For example, problem list updates were more likely for new patients than established ones, and alert acceptance was negatively correlated with alert frequency.
conclusionsProviders using the same EHR developed personalized patterns of use of EHR features. We conclude that physician-level usage of EHR features may be a valuable additional predictor in research on the effects of EHRs on healthcare quality and costs.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.