Umit Celik, Sandeep Rath, Saravanan Kesavan, Bradley R. Staats
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引用次数: 0
摘要
问题定义:医生每天花在电子病历 (EHR) 系统上的时间超过 5 小时,下班后花在电子病历工作上的时间超过 1 小时。许多研究都指出了过度使用电子病历和下班后工作的有害影响,包括医生倦怠、医生流失和预约延迟。然而,电子病历时间并不纯粹是一个外生因素,因为它取决于医生的使用行为,而医生的使用行为可能会产生重要的操作后果。有趣的是,之前的文献并没有严格考虑过这个问题。在本文中,我们研究了医生关于何时执行电子病历任务的工作流程决策如何影响:(1)使用电子病历的总时间和(2)下班后花费的时间。方法/结果:我们的数据包括一个大型学术医学中心家庭医学科 74 名医生的约 15 万个预约。我们的数据集包含预约进展和电子病历使用的详细过程级时间戳。我们发现,电子病历系统工作的效果取决于工作是在预约前还是预约后进行。预约前的电子病历工作会减少电子病历的总工作量和下班后花在电子病历上的时间。预约后的电子健康记录工作减少了电子健康记录的下班后时间,但增加了电子健康记录的总时间。我们发现,增加预约之间的空闲时间可以鼓励预约前和预约后的电子病历工作。管理意义:我们的研究结果不仅有助于我们更全面地了解次要任务的工作时间和结构,还有助于医疗保健管理者创建电子病历工作流程和预约时间表,以减少医生因过度使用电子病历而产生的倦怠感:本文已被《制造与印记》(Manufacturing & Service Operations Management)杂志的《运营管理前沿》(Frontiers in Operations Initiative)收录:本文的研究得到了北卡罗来纳大学教堂山分校凯南-弗拉格勒商学院健康商业中心的部分资助:在线附录见 https://doi.org/10.1287/msom.2023.0028 。
Frontiers in Operations: Does Physician’s Choice of When to Perform EHR Tasks Influence Total EHR Workload?
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. Post-appointment 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 post-appointment 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.History: This paper has been accepted in the Manufacturing & Service Operations Management Frontiers in Operations Initiative.Funding: The research conducted for this paper received partial funding from the Center of Business for Health at the Kenan-Flagler Business School, University of North Carolina at Chapel Hill.Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2023.0028 .