Interventions to mitigate EHR and documentation burden in health professions trainees: A scoping review

Presentation Time: 11:00 AM - 11:15 AM

Abstract Keywords: Documentation Burden, Workflow, Education and Training, Usability
Primary Track: Foundations
Programmatic Theme: Academic Informatics / LIEAF

Health professions (HP) trainees are in a unique position as they learn a chosen field while working within an electronic health record (EHR). EHR or documentation burden (EHR burden) affects trainees directly, although not all trainees have the same EHR access during training as they will after completing training. Efforts to mitigate EHR burden have been described for experienced HP, but less is understood for trainees.

Methods: We performed a scoping review to identify studies that measure trainee experience of interventions to mitigate EHR burden, applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extensions for Scoping Review (PRISMA-ScR) guidance, searching for scholarly and peer-reviewed sources. We then conducted a concept clarification, which can be used to modify an existing model or framework, cross-walking the scoping review corpus to a published workflow elements model, identifying intervenable points in trainee workflow.

Results: Our 4-database search yielded 820 records. We identified a corpus of 11 articles examining interventions to mitigate EHR burden and measuring the trainee experience. Interventions had varying effects on EHR burden, and trainee experience was most commonly measured through surveys and less commonly direct observation. We categorized interventions and then adapted the workflow model to the trainee EHR use workflow with 5 domain expert co-authors.

Conclusion: The model developed offers a starting place to consider points of intervention in the trainee workflow to mitigate EHR burden. Further research is needed to consider new interventions at various stages of the HP trainee workflow, in a range of clinical settings.

Speaker(s):
Deborah Levy, MD, MPH
Department of Veterans Affairs, VA-Connecticut Healthcare System / Yale School of Medicine

Author(s):
Sarah Rossetti, RN, PhD - Columbia University Department of Biomedical Informatics; Edward Melnick, MD - Yale University, School of Medicine; Cynthia Brandt, MD, MPH - Yale University, School of Medicine; Andrew Hamilton, MS/MLS - Oregon Health and Science University; Seppo Rinne, MD, PhD - VA Bedford Healthcare System; Dana Womack, PhD, RN, FAMIA - Oregon Health & Science University; Vishnu Mohan, MD, MBI, FACP, FAMIA - Oregon Health & Science University;