ArticleJournal of the American Medical Informatics Association : JAMIA2022
Team is brain: leveraging EHR audit log data for new insights into acute care processes.
Article in Journal of the American Medical Informatics Association : JAMIA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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.
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Who cites it
14 citing papers in PubMed, 24 citations in OpenAlex.
- Using electronic health record audit logs to identify pediatric intensive care unit teams.JAMIA open · 2026Article
- Unlocking the Full Potential of Health Care Teams: How Artificial Intelligence Can Help.JMIR AI · 2026Article
- Algorithmic Identification of the Daily Primary Frontline Clinician during Inpatient Medicine Encounters Using EHR Audit Log Data.Applied clinical informatics · 2026Article
- Enhanced Trauma Video Review With Computer Vision: Trauma Resuscitation Phase Segmentation and Procedure Detection.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Primary care staff members' experiences with managing electronic health record inbox messages.Journal of the American Medical Informatics Association : JAMIA · 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
- Unlocking inpatient workload insights with electronic health record event logs.Journal of hospital medicine · 2025Article
- Reimagining clinical AI: from clickstreams to clinical insights with EHR use metadata.npj health systems · 2025Review
- Article
- A Scalable and Extensible Logical Data Model of Electronic Health Record Audit Logs for Temporal Data Mining (RNteract): Model Conceptualization and Formulation.JMIR nursing · 2024Article
- Use of Epic Electronic Health Record System for Health Care Research: Scoping Review.Journal of medical Internet research · 2023Article
- Quantitative and qualitative methods advance the science of clinical workflow research.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Measurement and automation of workflows for improved clinician interaction: upgrading EHRs for 21st century healthcare value.Journal of the American Medical Informatics Association : JAMIA · 2022Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo determine whether novel measures of contextual factors from multi-site electronic health record (EHR) audit log data can explain variation in clinical process outcomes. MATERIALS AND
methodsWe selected one widely-used process outcome: emergency department (ED)-based team time to deliver tissue plasminogen activator (tPA) to patients with acute ischemic stroke (AIS). We evaluated Epic audit log data (that tracks EHR user-interactions) for 3052 AIS patients aged 18+ who received tPA after presenting to an ED at three Northern California health systems (Stanford Health Care, UCSF Health, and Kaiser Permanente Northern California). Our primary outcome was door-to-needle time (DNT) and we assessed bivariate and multivariate relationships with six audit log-derived measures of treatment team busyness and prior team experience.
resultsPrior team experience was consistently associated with shorter DNT; teams with greater prior experience specifically on AIS cases had shorter DNT (minutes) across all sites: (Site 1: -94.73, 95% CI: -129.53 to 59.92; Site 2: -80.93, 95% CI: -130.43 to 31.43; Site 3: -42.95, 95% CI: -62.73 to 23.17). Teams with greater prior experience across all types of cases also had shorter DNT at two sites: (Site 1: -6.96, 95% CI: -14.56 to 0.65; Site 2: -19.16, 95% CI: -36.15 to 2.16; Site 3: -11.07, 95% CI: -17.39 to 4.74). Team busyness was not consistently associated with DNT across study sites.
conclusionsEHR audit log data offers a novel, scalable approach to measure key contextual factors relevant to clinical process outcomes across multiple sites. Audit log-based measures of team experience were associated with better process outcomes for AIS care, suggesting opportunities to study underlying mechanisms and improve care through deliberate training, team-building, and scheduling to maximize team experience.
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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.