The Agency for Healthcare Research and Quality has funded a study to investigate the impact of electronic health records and meaningful use criteria on emergency department workflow at two New York City hospitals.
Mount Sinai Medical Center and New York-Presbyterian Hospital are participating in the study which will evaluate the impact of MU on clinician workflow, including information seeking, team interaction, and decision making in the context of clinicians use of EHRs. Three data collection methods will be used: clinician shadowing, log-files of EHR use, and sensor-based data collection using RFID technology to track the movement and interaction patterns of clinicians.
The New York Academy of Medicines Center for Cognitive Studies in Medicine and Public Health, led by Vimla Patel, senior research scientist and director of the center, received a four-year $1 million grant from AHRQ for the study.
This study promises to bridge science into practice and to influence policy based on the insights drawn from the investigation into clinician work activities, said Patel. Additionally, given that emergency departments are particularly challenging environments for measuring the impact of MU criteria implementations, we believe that our study will provide a benchmark for further extension into other ambulatory care settings.
However, according to the American Medical Association, the design and implementation of EHRs do not align with the cognitive and workflow requirements of physicians within and across specialties and practice settings. Last year, AMA and RAND Corp. conducted a study in which doctors identified EHRs as the leading cause of professional dissatisfaction, emotional fatigue, depersonalization and lost enthusiasm. In the study, doctors described poor EHR usability that did not match clinical workflows, time-consuming data entry, interference with face-to-face patient care, and overwhelming numbers of electronic messages and alerts.
Nonetheless, the New York Academy of Medicine argues that advances in health IT such as EHRs can reduce the burden of complexity on clinicians, potentially improving quality, safety, and efficiency of healthcare and that the impact in clinical contexts are of increased importance to the medical community given widespread adoption of EHR systems. As a result, NYAM is hoping that the lessons learned from its EHR workflow study of the complex emergency department environments at two New York City hospitals will generalize across other clinical and educational settings.
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