ArticleApplied clinical informatics2021
Measuring Electronic Health Record Use in the Pediatric ICU Using Audit-Logs and Screen Recordings.
Article in Applied clinical informatics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- The use of objective EHR-and schedule-based clinical workload and EHR use measures in predicting inpatient pediatric provider burnout.JAMIA open · 2026Article
- Mortality risk prediction from dense PICU data from patients with suspected infection: data-derived physiological trajectories outperform expert assessments when temporal resolution is high.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026Article
- Quantifying and Visualizing Emergency Physician Workflow: Observational Time-Motion Study.JMIR medical informatics · 2026Observational
- Identifying Electronic Health Record Tasks and Activity Using Computer Vision.Applied clinical informatics · 2025Article
- Association of EHR-Integrated Secure Messaging Use with Clinician Workload and Attention Switching.Journal of general internal medicine · 2025Article
- Does autotext usage decrease documentation time among resident physicians? A retrospective analysis of electronic health record usage data.JAMIA open · 2025Article
- Emerging Domains for Measuring Health Care Delivery With Electronic Health Record Metadata.Journal of medical Internet research · 2025Review
- Consistency is key: documentation distribution and efficiency in primary care.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Assessing Electronic Health Record (EHR) Use during a Major EHR Transition: An Innovative Mixed Methods Approach.Journal of general internal medicine · 2023Article
- Effect of Tailored Coaching on Physicians' Electronic Health Record Proficiency and User Experience: A Randomized Crossover Study.Mayo Clinic proceedings. Digital health · 2023Article
- Identifying a Clinical Informatics or Electronic Health Record Expert Witness for Medical Professional Liability Cases.Applied clinical informatics · 2023Article
- Using event logs to observe interactions with electronic health records: an updated scoping review shows increasing use of vendor-derived measures.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Using electronic health record audit log data for research: insights from early efforts.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Accuracy of Physician Electronic Health Record Usage Analytics using Clinical Test Cases.Applied clinical informatics · 2022Article
- Clinical Decision Support Stewardship: Best Practices and Techniques to Monitor and Improve Interruptive Alerts.Applied clinical informatics · 2022Review
- Predicting physician burnout using clinical activity logs: Model performance and lessons learned.Journal of biomedical informatics · 2022Article
- Predicting next-day discharge via electronic health record access logs.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Engaging Housestaff as Informatics Collaborators: Educational and Operational Opportunities.Applied clinical informatics · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundTime spent in the electronic health record (EHR) has been identified as an important unit of measure for health care provider clinical activity. The lack of validation of audit-log based inpatient EHR time may have resulted in underuse of this data in studies focusing on inpatient patient outcomes, provider efficiency, provider satisfaction, etc. This has also led to a dearth of clinically relevant EHR usage metrics consistent with inpatient provider clinical activity.
objectiveThe aim of our study was to validate audit-log based EHR times using observed EHR-times extracted from screen recordings of EHR usage in the inpatient setting.
methodsThis study was conducted in a 36-bed pediatric intensive care unit (PICU) at Lucile Packard Children's Hospital Stanford between June 11 and July 14, 2020. Attending physicians, fellow physicians, hospitalists, and advanced practice providers with ≥0.5 full-time equivalent (FTE) for the prior four consecutive weeks and at least one EHR session recording were included in the study. Citrix session recording player was used to retrospectively review EHR session recordings that were captured as the provider interacted with the EHR.
resultsEHR use patterns varied by provider type. Audit-log based total EHR time correlated strongly with both observed total EHR time (
conclusionOur study found inpatient audit-log based EHR time to correlate strongly with observed EHR time among pediatric critical care providers. These findings support the use of audit-log based EHR-time as a surrogate measure for inpatient provider EHR use, providing an opportunity for researchers and other stakeholders to leverage EHR audit-log data in measuring clinical activity and tracking outcomes of workflow improvement efforts longitudinally and across provider groups.
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