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Pauly RP, Stafinski T, Koosha H, Avdagovska M, Hadizadeh M, Bigam D, Graham T, Kuziemsky C, Kassam N, Menon D
After-Hours Use of the Electronic Health Record Among Medical and Surgical Specialists After Implementation of a System-Wide Integrated Clinical Information System in Alberta, Canada: Longitudinal Descriptive Study
Afterhours usage of the electronic health record among medical and surgical specialists after implementation of a system wide integrated clinical information system in Alberta, Canada: A longitudinal descriptive study
Robert P. Pauly;
Tania Stafinski;
Helia Koosha;
Melita Avdagovska;
Maliheh Hadizadeh;
David Bigam;
Timothy Graham;
Craig Kuziemsky;
Narmin Kassam;
Devidas Menon
ABSTRACT
Background:
Studies suggest the introduction of electronic health records (EHRs) has decreased efficiency of clinical practice and increased clinician workload for United States (US)-based physicians. Less is known about other healthcare settings, nor whether markers of efficiency and workload change over time.
Objective:
This study reports on afterhours EHR use [pajama time and time outside scheduled hours (TOSH)] among diverse specialists and tracks these parameters longitudinally.
Methods:
A longitudinal descriptive study of medical and surgical specialists followed from the introduction of a system-wide EHR in 2019 to 2022 at a large quaternary teaching hospital in Edmonton, Canada. Pajama Time and TOSH were extracted from the EHR on an Epic System platform, and monitored over time. Clinicians were stratified according to clinical group (medical and surgical) and workload (clinical full-time equivalent).
Results:
Seventy-one medical and surgical specialists participated in this study, spending anywhere from 24 to 40 minutes per day on pajama time and 32 to 55 minutes per day on TOSH depending on clinician grouping. Both pajama time and TOSH increased significantly over the 22- and 33-month observation periods for both variables, respectively.
Conclusions:
Afterhours EHR use in this Canadian cohort of medical and surgical specialists is similar to what is reported in US literature, though the drivers are likely to be different. Perhaps surprisingly, these markers increased over time despite presumed improved familiarity with the EHR. The extent to which this affects clinician wellbeing and work-life integration cannot be determined from these results though there may be cause for concern.
Citation
Please cite as:
Pauly RP, Stafinski T, Koosha H, Avdagovska M, Hadizadeh M, Bigam D, Graham T, Kuziemsky C, Kassam N, Menon D
After-Hours Use of the Electronic Health Record Among Medical and Surgical Specialists After Implementation of a System-Wide Integrated Clinical Information System in Alberta, Canada: Longitudinal Descriptive Study