ArticleJournal of the American Medical Informatics Association : JAMIA2018
Secondary use of electronic health record data for clinical workflow analysis.
Article in Journal of the American Medical Informatics Association : JAMIA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Secondary use of health records for prediction, detection, and treatment planning in the clinical decision support system: a systematic review.BMC medical informatics and decision making · 2025Pooled 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
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- Addressing Data Quality Challenges in Lung Cancer Data Within the Observational Medical Outcomes Partnership Common Data Model: Observational Study.Journal of medical Internet research · 2026Observational
- Reimagining clinical AI: from clickstreams to clinical insights with EHR use metadata.npj health systems · 2025Review
- Machine Learning Operations in Health Care: A Scoping Review.Mayo Clinic proceedings. Digital health · 2024Review
- Effects of a QI intervention on pediatric asthma treatment using patient outcomes and workflow in an emergency department.The Journal of asthma : official journal of the Association for the Care of Asthma · 2023Article
- Evaluating the Impact of a Point-of-Care Cardiometabolic Clinical Decision Support Tool on Clinical Efficiency Using Electronic Health Record Audit Log Data: Algorithm Development and Validation.JMIR medical informatics · 2022Article
- OARD: Open annotations for rare diseases and their phenotypes based on real-world data.American journal of human genetics · 2022Article
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- Characterization of Electronic Health Record Use Outside Scheduled Clinic Hours Among Primary Care Pediatricians: Retrospective Descriptive Task Analysis of Electronic Health Record Access Log Data.JMIR medical informatics · 2022Article
- Pragmatic considerations and approaches for measuring staff time as an implementation cost in health systems and clinics: key issues and applied examples.Implementation science communications · 2022Article
- Principles for Designing and Developing a Workflow Monitoring Tool to Enable and Enhance Clinical Workflow Automation.Applied clinical informatics · 2022Article
- Predicting next-day discharge via electronic health record access logs.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Otolaryngology resident clinic participation and attending electronic health record efficiency-A user activity logs study.Laryngoscope investigative otolaryngology · 2021Article
- Measuring Electronic Health Record Use in the Pediatric ICU Using Audit-Logs and Screen Recordings.Applied clinical informatics · 2021Article
- Exploring the lengthiest ambulatory breast surgery clinic appointments: is the patient the problem?Gland surgery · 2021Article
- Behind the clock: elucidating factors contributing to longer clinic appointment duration and patient wait time.BMC health services research · 2021Article
- An electronic health record (EHR) log analysis shows limited clinician engagement with unsolicited genetic test results.JAMIA open · 2021Article
- Application of the Sight Outcomes Research Collaborative Ophthalmology Data Repository for Triaging Patients With Glaucoma and Clinic Appointments During Pandemics Such as COVID-19.JAMA ophthalmology · 2020Article
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Authors and funding
8 authors.
Funding
Abstract
Objective: Outpatient clinics lack guidance for tackling modern efficiency and productivity demands. Workflow studies require large amounts of timing data that are prohibitively expensive to collect through observation or tracking devices. Electronic health records (EHRs) contain a vast amount of timing data - timestamps collected during regular use - that can be mapped to workflow steps. This study validates using EHR timestamp data to predict outpatient ophthalmology clinic workflow timings at Oregon Health and Science University and demonstrates their usefulness in 3 different studies. Materials and Methods: Four outpatient ophthalmology clinics were observed to determine their workflows and to time each workflow step. EHR timestamps were mapped to the workflow steps and validated against the observed timings. Results: The EHR timestamp analysis produced times that were within 3 min of the observed times for >80% of the appointments. EHR use patterns affected the accuracy of using EHR timestamps to predict workflow times. Discussion: EHR timestamps provided a reasonable approximation of workflow and can be used for workflow studies. They can be used to create simulation models, analyze EHR use, and quantify the impact of trainees on workflow. Conclusion: The secondary use of EHR timestamp data is a valuable resource for clinical workflow studies. Sample timestamp data files and algorithms for processing them are provided and can be used as a template for more studies in other clinical specialties and settings.
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Registered trials
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.