Team is brain: leveraging EHR audit log data for new insights into acute care processes
Presenter
Christian Rose, MD
Manager
Hanyin Wang
Moderator
Lu He, BS
Watch the Recording
Statement of Purpose
Research using Electronic Health Record (EHR) audit- or event-logs is a rapidly growing field of study in healthcare that focuses on the analysis and evaluation of users' granular interactions with the medical record. These logs record actions taken within a healthcare system, such as patient records being accessed or medication orders being placed. It is known that audit logs can provide valuable insights into the functioning of healthcare systems, including identifying areas for improvement and security monitoring. It has also been used to better understand the practice patterns of clinicians both at the point of care and outside of the hospital, which can be used to clarify the role of the EHR in physician burnout or to prevent it by improving clinical workflows.
However, less is known about the summation of work across providers in a department or institution and how this relates to specific clinical outcomes of interest. In the emergency department, this context of care is thought to have an outsized impact on the ability to deliver care to the most seriously ill patients (e.g., Acute Ischemic Stroke) due to the impact of clinical workloads, cognitive burden, task-switching, or even experience with other team members - all of which can be identified from the audit log.
Our multi-center, inter-institution collaboration sought to determine whether novel measures of clinical contextual factors from multi-site EHR audit log data can explain variation in process outcomes. We found that while team "busyness" was not highly associated with differences in door-to-needle times, prior experience with team members was strongly associated with faster door-to-needle times, suggesting a potentially high-yield method of evaluation and point of intervention for the management of emergent conditions.
Learning Objectives
After participating in the webinar, attendees should be able to:
- Define the role and scope of the EHR audit log in healthcare
- Generate examples of current audit log use and research
- Recognize the impact of "context" on healthcare delivery
- Understand how to use the audit log to develop contextual measures and understanding
- Propose potential areas where the audit log may offer new insights into healthcare delivery