SynthesisJournal of the American Medical Informatics Association : JAMIA2020
Using electronic health record audit logs to study clinical activity: a systematic review of aims, measures, and methods.
Synthesis in Journal of the American Medical Informatics Association : JAMIA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
80 citing papers in PubMed.
- Effect of restricting electronic health records on clinician efficiency: substudy of a randomized clinical trial.Journal of the American Medical Informatics Association : JAMIA · 2023Trial
- Quantitative Insights From Nursing Workload Measurement: An Artificial Intelligence-Driven Approach.Military medicine · 2026Article
- Quantifying and Visualizing Emergency Physician Workflow: Observational Time-Motion Study.JMIR medical informatics · 2026Observational
- Physician-Reported Safety Outcomes of AI-Generated Hospital Course Summaries.JAMA network open · 2026Article
- Algorithmic Identification of the Daily Primary Frontline Clinician during Inpatient Medicine Encounters Using EHR Audit Log Data.Applied clinical informatics · 2026Article
- EHR-derived cognitive load is associated with guideline-concordant statin initiation in primary care.BMC medical informatics and decision making · 2026Article
- Time Burden of Electronic Medical Records on Nurses and Physicians in Saudi Arabia: Occurrence, Predictors, and Challenges-A Mixed-Methods Study.Healthcare (Basel, Switzerland) · 2026Article
- Phenotyping the Transfusion Management Experience of Trainees Using Electronic Health Records.Anesthesia and analgesia · 2026Observational
- A nursing perspective on human-AI collaboration in personalized breast cancer care pathways.Frontiers in oncology · 2026Article
- The role of electronic health records systems in de-implementing low-value care in primary care: a scoping review.Implementation science communications · 2025Review
- Evaluating Cognitive Load in Clinical Workflows Highlights Leverage Points for Guideline-Concordant Statin Initiation.Research square · 2025Article
- Utilization of Generative AI-drafted Responses for Managing Patient-Provider Communication.NPJ digital medicine · 2025Article
- Critical Success Factors Influencing the Acceptance of a Casemix-Based Hospital Information System: Cross-Sectional Study.Journal of medical Internet research · 2025Article
- Association Between Conversational Multitasking and Clinician Work Behaviors at a Large US Health Care System: Cohort Study.Journal of medical Internet research · 2025Observational
- Electronic health record activity changes around new decision support implementation: monitoring using audit logs and topic modeling.JAMIA open · 2025Article
- Narrative Review of Electronic Health Record Systems in Anesthesia: Benefits, Risks, and Medico-Legal Considerations in the United States of America.Journal of medical systems · 2025Review
- Digital supervision in the clinical learning environment: Characterizing teamwork in the electronic health record.Journal of hospital medicine · 2025Article
- Emerging Domains for Measuring Health Care Delivery With Electronic Health Record Metadata.Journal of medical Internet research · 2025Review
- An electronic health record metadata-mining approach to identifying patient-level interprofessional clinician teams in the intensive care unit.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- An unclear partnership: key questions about physician and advanced practice provider collaboration in primary care.Health affairs scholar · 2025Article
20 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
objectiveTo systematically review published literature and identify consistency and variation in the aims, measures, and methods of studies using electronic health record (EHR) audit logs to observe clinical activities. MATERIALS AND
methodsIn July 2019, we searched PubMed for articles using EHR audit logs to study clinical activities. We coded and clustered the aims, measures, and methods of each article into recurring categories. We likewise extracted and summarized the methods used to validate measures derived from audit logs and limitations discussed of using audit logs for research.
resultsEighty-five articles met inclusion criteria. Study aims included examining EHR use, care team dynamics, and clinical workflows. Studies employed 6 key audit log measures: counts of actions captured by audit logs (eg, problem list viewed), counts of higher-level activities imputed by researchers (eg, chart review), activity durations, activity sequences, activity clusters, and EHR user networks. Methods used to preprocess audit logs varied, including how authors filtered extraneous actions, mapped actions to higher-level activities, and interpreted repeated actions or gaps in activity. Nineteen studies validated results (22%), but only 9 (11%) through direct observation, demonstrating varying levels of measure accuracy. DISCUSSION: While originally designed to aid access control, EHR audit logs have been used to observe diverse clinical activities. However, most studies lack sufficient discussion of measure definition, calculation, and validation to support replication, comparison, and cross-study synthesis.
conclusionEHR audit logs have potential to scale observational research but the complexity of audit log measures necessitates greater methodological transparency and validated standards.
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What OpenQuestion holds
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.