Dataset Information

Association between state-level malpractice environment and clinician electronic health record (EHR) time.

ABSTRACT:

Objective

Clinicians spend significant time working in the electronic health record (EHR). The US is an outlier in EHR time, suggesting that EHR-related work may be driven in part by the legal environment and threat of malpractice. To assess this, we evaluate the association between state-level malpractice climate and clinician time spent in the EHR.

Materials and methods

We use EHR metadata from 351 ambulatory care health systems in the United States using Epic from January-August 2019 combined with state-level data on malpractice incidence and payouts. We used descriptive statistics to measure variation in clinician EHR time, including total EHR time, documentation time per day, and after-hours EHR time per day. Multi-variable regression evaluated the association between clinicians in high malpractice states and EHR use.

Results

We found no association between location in a state in the top-quartile of malpractice payouts and time spent in the EHR per day, time spent in the EHR outside of scheduled hours, or time spent documenting per day, except for a subgroup of the clinicians in the highest malpractice specialties, where there was a small increase in EHR time per day (B = 6.08 min, P < 0.001) and time spent documenting notes (B = 2.77 min, P < 0.001).

Discussion

State-level differences in malpractice incidence are unlikely to be a significant driver of EHR work for most clinicians.

Conclusion

Policymakers seeking to address EHR documentation burden should examine burden driven by other socio-technical demands on clinician time, such as billing or quality measurement.

SUBMITTER: Holmgren AJ

PROVIDER: S-EPMC9093025 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Association between state-level malpractice environment and clinician electronic health record (EHR) time.

Holmgren A Jay AJ Rotenstein Lisa L Downing Norman Lance NL Bates David W DW Schulman Kevin K

Journal of the American Medical Informatics Association : JAMIA 20220501 6

<h4>Objective</h4>Clinicians spend significant time working in the electronic health record (EHR). The US is an outlier in EHR time, suggesting that EHR-related work may be driven in part by the legal environment and threat of malpractice. To assess this, we evaluate the association between state-level malpractice climate and clinician time spent in the EHR.<h4>Materials and methods</h4>We use EHR metadata from 351 ambulatory care health systems in the United States using Epic from January-Augus ...[more]

PMID: 35271723

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Dataset Information

Association between state-level malpractice environment and clinician electronic health record (EHR) time.

Objective

Materials and methods

Results

Discussion

Conclusion

Publications

Association between state-level malpractice environment and clinician electronic health record (EHR) time.

Similar Datasets

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