Frontiers in Operations: Does Physician's Choice of When to Perform EHR Tasks Influence Total EHR Workload?

• 成果类型: Article
• 署名作者: Celik, Umit; Rath, Sandeep; Kesavan, Saravanan; Staats, Bradley R.
• 署名单位: University of North Carolina; University of North Carolina Chapel Hill; University of North Carolina School of Medicine
• 刊物名称: M&SOM-MANUFACTURING & SERVICE OPERATIONS MANAGEMENT
• ISSN/ISSBN: 1523-4614
• DOI: 10.1287/msom.2023.0028
• 发表日期: 2024
• 关键词: Electronic Health Record (EHR); task-switching; healthcare operations; service operations

摘要

Problem definition: Physicians spend more than five hours a day working on Electronic Health Record (EHR) systems and more than an hour doing EHR tasks after the end of the workday. Numerous studies have identified the detrimental effects of excessive EHR use and after-hours work, including physician burnout, physician attrition, and appointment delays. However, EHR time is not purely an exogenous factor because it depends on physician usage behavior that could have important operational consequences. Interestingly, prior literature has not considered this topic rigorously. In this paper, we investigate how physicians' workflow decisions on when to perform EHR tasks affect: (1) total time on EHR and (2) time spent after work. Methodology/results: Our data comprise around 150,000 appointments from 74 physicians from a large Academic Medical Center Family Medicine unit. Our data set contains detailed, process -level time stamps of appointment progression and EHR use. We find that the effect of working on EHR systems depends on whether the work is done before or after an appointment. Pre -appointment EHR work reduces total EHR workload and after -work hours spent on EHR. Postappointment EHR work reduces after -work hours on EHR but increases total EHR time. We find that increasing idle time between appointments can encourage both pre- and postappointment EHR work. Managerial implications: Our results not only help us understand the timing and structure of work on secondary tasks more generally but also will help healthcare administrators create EHR workflows and appointment schedules to reduce physician burnout associated with excessive EHR use.