Few Family Medicine Physicians Experience Ideal Interoperability

2025 Clinical Informatics Conference On Demand

2025 Clinical Informatics Conference 25x5 Presentation

Presentation Time: 08:00 AM - 08:20 AM

Abstract Keywords: Health Information Exchange (HIE), Usability and Measuring User Experience, Interoperability
Primary Track: Documentation Burden, Clinician Well-Being and Care Outcomes
Programmatic Theme: Usability, Efficiency, and User Experience

In a survey of over 7500 family medicine physicians with a 100% response rate in 2024, only a small fraction of physicians reported ideal interoperability experiences for clinical data (for instance, just 13% reported ideal interoperability for medications), defined as often automatically obtaining documents from outside organizations, easily finding the document, and easily finding information within the document in their EHR.
Speaker(s):
Jordan Everson, PhD
Office of the National Coordinator for Health Information Technology

Author(s):
Julia Adler-Milstein, PhD - UCSF School of Medicine; Robert Phillips, MD MSPH; Andrew Bazemore; Vaishali Patel, PhD MPH - Assistant Secretary for Technology Policy/ Office of the National Coordinator for Health IT/;

Capturing the Visitome: Sociotechnical Ethnography Through Clinical Video in the Observer Repository

2025 Clinical Informatics Conference On Demand

2025 Clinical Informatics Conference 25x5 Presentation

Presentation Time: 08:20 AM - 08:40 AM

Abstract Keywords: Artificial Intelligence/Machine Learning, Workflow Efficiency, Documentation Burden, Patient Safety, Innovation in Digital Care, Usability and Measuring User Experience, Data Privacy and Secondary Use, Ambient documentation
Primary Track: Documentation Burden, Clinician Well-Being and Care Outcomes
Programmatic Theme: Informatics-Driven Value-Based Healthcare

The Observer Repository includes video recordings of clinical encounters, electronic health record (EHR) data, and patient and provider satisfaction information. This dataset aims to address challenges in healthcare including clinician burnout, inefficient EHR workflows, and limited visit access by innovators by enabling research, testing hypotheses about improving primary care, and bridging engineering and healthcare. The Observer Repository uses a privacy- preserving pipeline, making it an accessible resource for understanding patient-provider interactions and improving care quality.
Speaker(s):
Basam Alasaly, Biomedical Informatics, M.S.
Perelman School of Medicine at the University of Pennsylvania

Author(s):
Basam Alasaly, Biomedical Informatics, M.S. - Perelman School of Medicine at the University of Pennsylvania; Sriharsha Mopidevi, Master of Science - University of Pennsylvania; Stacy Iannone, PhD, MS - University of Pennsylvania; Amarpreet Kaur, MHS - University of Pennsylvania; Ross Koppel, PhD, FACMI, FIAHSI - University of Pennsylvania & University at Buffalo; Kevin Johnson, MD, MS - University of Pennsylvania;

Evaluating the Adoption of Billing Patient Messages as ‘E-Visits’ and Impact on Physician Burnout

2025 Clinical Informatics Conference On Demand

2025 Clinical Informatics Conference 25x5 Presentation

Presentation Time: 08:40 AM - 09:00 AM

Abstract Keywords: Clinician Burnout, EHR Implementation and Optimization, Care Delivery Models
Primary Track: Documentation Burden, Clinician Well-Being and Care Outcomes
Programmatic Theme: Usability, Efficiency, and User Experience

Clinician-patient messaging grew dramatically at the beginning of the pandemic and has persisted at high levels. In 2020, CMS allowed new reimbursement for patient medical advice requests (e-visits): secure messages that require both medical decision-making and at least five minutes of clinician time. In response, several health systems implemented clinician-initiated billing for these messages, including UCSF Health in November 2021.

To understand adoption and efficacy of this intervention, we first used Epic Clarity EHR metadata to identify physician adopters of e-visits and matched these to self-reported physician wellbeing survey data. We used a difference-in-differences analysis with ordinary least squares regression to assess how e-visit adopter physicians’ responses on overall burnout and callousness towards others changed compared to those who did not adopt e-visits. We then conducted semi-structured interviews with UCSF physician adopters of e-visit billing in order to understand how they opted to employ this functionality and perceived its effect on symptoms of burnout.

Our quantitative results show that e-visit adopters reported significant reductions in callousness towards others. Interviews revealed that the initial implementation did not align with how physicians perceive this work. Specifically, interviewees cited low valuation, additional clicks, and discomfort initiating billing as barriers to billing for e-visits to a fuller extent and as factors contributing to burnout. However, physicians were optimistic about its potential to assign value to an important care modality and alleviate burnout symptoms.

Future efforts should focus on aligning incentives to encourage physicians to continue utilizing this care modality and adopt billing for it.
Speaker(s):
Sarah Rosenthal, BA
University of California San Francisco

Author(s):
Julia Adler-Milstein, PhD - UCSF School of Medicine; A J Holmgren, PhD - University of California, San Francisco;