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Educational Intervention to Increase Physician Satisfaction and Effectiveness With a New Electronic Health Record

Not Applicable
Completed
Conditions
Attitude of Health Personnel
Interventions
Other: One-on-one physician training
Other: Usual training
Registration Number
NCT02015702
Lead Sponsor
The Reading Hospital and Medical Center
Brief Summary

This study was intended to test the effects of adding a one-on-one educational intervention taught by a physician to a physician during their clinical work to improve their acceptance and satisfaction with a new inpatient electronic health record and ordering system.

Detailed Description

This study was a randomized, parallel , non- blinded controlled trial of real-time, focused educational interventions in an intervention arm compared with usual training and support in the control arm. Improvement in performance, defined as the time between opening and closing a progress note, and number of notes completed after shift , were the primary outcomes. Physician satisfaction was a secondary outcome. Participants from one 550-bed Academic Independent Medical Center were invited to participate if they were full-time hospitalists or residents in internal medicine with no prior experience with the EPIC electronic health record.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
44
Inclusion Criteria
  • Internal Medicine physicians and resident physicians with inpatient clinical duties at the time of the EPIC electronic health record go-live (Feb 4, 2013)
Exclusion Criteria
  • Physicians whose duties did not include regular admissions and discharge of patients
  • Physicians whose work was limited to teaching
  • Physicians with prior experience in using EPIC systems for inpatient care .
  • Physician assistants and nurse practitioners

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
One-on-one physician trainingUsual trainingOne-on-one physician training Physicians in the experimental arm were visited by a instructing physician at a computer while performing clinical duties who had observed others to identify best practices. Instructors watched subjects' work, looking for a specific tip that could be applied to the current work, then demonstrated the tip, and answered any questions the subject had about using or applying this new technique .
One-on-one physician trainingOne-on-one physician trainingOne-on-one physician training Physicians in the experimental arm were visited by a instructing physician at a computer while performing clinical duties who had observed others to identify best practices. Instructors watched subjects' work, looking for a specific tip that could be applied to the current work, then demonstrated the tip, and answered any questions the subject had about using or applying this new technique .
Usual trainingUsual trainingUsual training. This group will get the usual specified training for learning to use our electronic health record. Both groups received 12 hours of EPIC classroom training, exposure to the EPIC e-learning modules, user acceptability testing classes, and unlimited time on the EPIC 'playground', a site to practice on virtual patients. All had 90 days of elbow support with an EPIC-training non-physician technician, who were visible and available on all inpatient wards, as well as access to a physician-only support line available at all hours.
Primary Outcome Measures
NameTimeMethod
Time to complete a progress notewithin 1 week of note completion

the primary outcome measure will be time to complete a progress note. this is defined as the difference between the recorded time of opening the note and the recorded time the note was signed in the EPIC electronic health record system.

Secondary Outcome Measures
NameTimeMethod
Physician Satisfaction with EPIC Electronic Health Recordat baseline, 15-20 shifts, and 35-40 shifts

We asked the participants this question:

How comfortable are you specifically using the EPIC program for inpatient practice?" at baseline, midpoint (after working 15-20 shifts), and end of the study (after working 35-40 shifts).

Number of notes completed after shiftwithin 1 week of posting note

Shifts are 7 a.m. - 7 p.m for doctors assigned to daytime work. We defined a note completed after shift as any note with a signed time that is after 7 p.m. on the day of a shift worked.

Trial Locations

Locations (1)

Reading Health System

🇺🇸

West Reading, Pennsylvania, United States

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