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

Sponsor

The Reading Hospital and Medical Center (Other)

Overall Status

Completed

CT.gov ID

NCT02015702

Collaborator

(none)

Enrollment

Location

Arms

12.4

Duration (Months)

3.5

Patients Per Site Per Month

Study Details

Study Description

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.

Condition or Disease	Intervention/Treatment	Phase
Attitude of Health Personnel	Other: One-on-one physician training Other: Usual training	N/A

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 Design

Study Type:

Interventional

Actual Enrollment :

44 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

None (Open Label)

Primary Purpose:

Other

Official Title:

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

Study Start Date :

Jan 1, 2013

Actual Primary Completion Date :

Jun 1, 2013

Actual Study Completion Date :

Jan 14, 2014

Arms and Interventions

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.

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

Outcome Measures

Primary Outcome Measures

Time to complete a progress note [within 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

Number of notes completed after shift [within 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.
Physician Satisfaction with EPIC Electronic Health Record [at 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).

Eligibility Criteria

Criteria

Ages Eligible for Study:

25 Years to 65 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

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

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Reading Health System	West Reading	Pennsylvania	United States	19612

Sponsors and Collaborators

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 Documents (Full-Text)

None provided.

More Information

Publications

None provided.

Responsible Party:

The Reading Hospital and Medical Center

ClinicalTrials.gov Identifier:

NCT02015702

Other Study ID Numbers:

ReadingHMC-IRB-045-12

First Posted:

Dec 19, 2013

Last Update Posted:

May 28, 2021

Last Verified:

Dec 1, 2013

Keywords provided by The Reading Hospital and Medical Center

Physicians

Electronic Health Record

Education

Study Results

No Results Posted as of May 28, 2021