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

Interventions to Increase Physician Effectiveness and Acceptance of a Electronic Health Record System

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.

Study Overview

• Status: Completed
• Conditions: Attitude of Health Personnel
• Intervention / Treatment: Other: One-on-one physician training; Other: Usual training

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.

• Study Type: Interventional
• Enrollment (Actual): 44
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • West Reading, Pennsylvania, United States, 19612
      • Reading Health System

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 25 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

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 Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: One-on-one physician training; One-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 .	Other: One-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 .; Other: Usual training; Usual training included online e-modules, 12 hours of classroom time, practice in the EPIC Playground, user acceptability training classes,non-physician technical support on all of the floors, and a physician-only help line.
Active Comparator: Usual training; Usual 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.	Other: Usual training; Usual training included online e-modules, 12 hours of classroom time, practice in the EPIC Playground, user acceptability training classes,non-physician technical support on all of the floors, and a physician-only help line.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to complete a progress note	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.	within 1 week of note completion

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of notes completed after shift	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.	within 1 week of posting note
Physician Satisfaction with EPIC Electronic Health Record	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).	at baseline, 15-20 shifts, and 35-40 shifts

Collaborators and Investigators

• Sponsor: The Reading Hospital and Medical Center
• Investigators: Principal Investigator: Leena Jalota, MBBS, Reading Health System; Study Director: Anthony A Donato, MD MHPE, Reading Health System

Study record dates

Study Major Dates

• Study Start: January 1, 2013
• Primary Completion (Actual): June 1, 2013
• Study Completion (Actual): January 14, 2014

Study Registration Dates

• First Submitted: December 13, 2013
• First Submitted That Met QC Criteria: December 13, 2013
• First Posted (Estimate): December 19, 2013

Study Record Updates

• Last Update Posted (Actual): May 28, 2021
• Last Update Submitted That Met QC Criteria: May 27, 2021
• Last Verified: December 1, 2013

More Information

Terms related to this study

• Keywords: Education; Physicians; Electronic Health Record
• Other Study ID Numbers: ReadingHMC-IRB-045-12