{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T02:31:09Z","timestamp":1770690669006,"version":"3.49.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T00:00:00Z","timestamp":1605744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["T15LM011271"],"award-info":[{"award-number":["T15LM011271"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["T15LM012502"],"award-info":[{"award-number":["T15LM012502"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Electronic health record (EHR) log data capture clinical workflows and are a rich source of information to understand variation in practice patterns. Variation in how EHRs are used to document and support care delivery is associated with clinical and operational outcomes, including measures of provider well-being and burnout. Standardized measures that describe EHR use would facilitate generalizability and cross-institution, cross-vendor research. Here, we describe the current state of outpatient EHR use measures offered by various EHR vendors, guided by our prior conceptual work that proposed seven core measures to describe EHR use. We evaluate these measures and other reporting options provided by vendors for maturity and similarity to previously proposed standardized measures. Working toward improved standardization of EHR use measures can enable and accelerate high-impact research on physician burnout and job satisfaction as well as organizational efficiency and patient health.<\/jats:p>","DOI":"10.1093\/jamia\/ocaa266","type":"journal-article","created":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T20:39:23Z","timestamp":1603744763000},"page":"955-959","source":"Crossref","is-referenced-by-count":46,"title":["Measures of electronic health record use in outpatient settings across vendors"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5271-7690","authenticated-orcid":false,"given":"Sally L","family":"Baxter","sequence":"first","affiliation":[{"name":"Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA"},{"name":"Health Sciences Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA"}]},{"given":"Nate C","family":"Apathy","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"Regenstrief Institute, Indianapolis, Indiana, USA"},{"name":"At the time this project was completed, Dr. Apathy was a doctoral candidate in the Department of Health Policy & Management at the University of Indiana Richard M. Fairbanks School of Public Health"}]},{"given":"Dori A","family":"Cross","sequence":"additional","affiliation":[{"name":"Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA"}]},{"given":"Christine","family":"Sinsky","sequence":"additional","affiliation":[{"name":"American Medical Association, Chicago, Illinois, USA"}]},{"given":"Michelle R","family":"Hribar","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Sciences University, Portland, Oregon, USA"}]}],"member":"286","published-online":{"date-parts":[[2020,11,19]]},"reference":[{"key":"2021042419044960800_ocaa266-B1"},{"key":"2021042419044960800_ocaa266-B2","author":"Myrick","year":"2019"},{"issue":"4","key":"2021042419044960800_ocaa266-B3","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1093\/jamia\/ocz220","article-title":"Electronic health records and burnout: time spent on the electronic health record after hours and message volume associated with exhaustion but not with cynicism among primary care clinicians","volume":"27","author":"Adler-Milstein","year":"2020","journal-title":"J Am Med Inform Assoc"},{"key":"2021042419044960800_ocaa266-B4","first-page":"SP345","article-title":"The impact of electronic health record use on physician productivity","volume":"19","author":"Adler-Milstein","year":"2013","journal-title":"Am J Manag Care"},{"issue":"7","key":"2021042419044960800_ocaa266-B5","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/j.mayocp.2016.05.007","article-title":"Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction","volume":"91","author":"Shanafelt","year":"2016","journal-title":"Mayo Clin Proc"},{"issue":"6","key":"2021042419044960800_ocaa266-B6","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1111\/joim.12752","article-title":"Physician burnout: contributors, consequences and solutions","volume":"283","author":"West","year":"2018","journal-title":"J Intern Med"},{"issue":"7","key":"2021042419044960800_ocaa266-B7","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1377\/hlthaff.2018.05509","article-title":"Physicians\u2019 well-being linked to in-basket messages generated by algorithms in electronic health records","volume":"38","author":"Tai-Seale","year":"2019","journal-title":"Health Aff (Millwood)"},{"issue":"5","key":"2021042419044960800_ocaa266-B8","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1093\/jamia\/ocv138","article-title":"Effects of health information technology on patient outcomes: a systematic review","volume":"23","author":"Brenner","year":"2016","journal-title":"J Am Med Inform Assoc"},{"key":"2021042419044960800_ocaa266-B9","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1093\/jamia\/ocz196","article-title":"Using electronic health record audit logs to study clinical activity: a systematic review of aims, measures, and methods","author":"Rule","year":"2020","journal-title":"J Am Med Inform Assoc"},{"issue":"11","key":"2021042419044960800_ocaa266-B10","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.1007\/s11606-019-05025-3","article-title":"Variation in physicians\u2019 electronic health record documentation and potential patient harm from that variation","volume":"34","author":"Cohen","year":"2019","journal-title":"J Gen Intern Med"},{"key":"2021042419044960800_ocaa266-B11","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1093\/jamia\/ocz223","article-title":"Metrics for assessing physician activity using electronic health record log data","author":"Sinsky","year":"2020","journal-title":"J Am Med Inform Asso"},{"issue":"3","key":"2021042419044960800_ocaa266-B12","doi-asserted-by":"crossref","first-page":"169","DOI":"10.7326\/M18-3684","article-title":"Physician time spent using the electronic health record during outpatient encounters: a descriptive study","volume":"172","author":"Overhage","year":"2020","journal-title":"Ann Intern Med"},{"issue":"4","key":"2021042419044960800_ocaa266-B13","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1093\/jamia\/ocz222","article-title":"Have you got the time? Challenges using vendor electronic health record metrics of provider efficiency","volume":"27","author":"Hron","year":"2020","journal-title":"J Am Med Inform Assoc"},{"issue":"5","key":"2021042419044960800_ocaa266-B14","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1370\/afm.2121","article-title":"Tethered to the EHR: primary care physician workload assessment using EHR event log data and time-motion observations","volume":"15","author":"Arndt","year":"2017","journal-title":"Ann Fam Med"},{"issue":"1","key":"2021042419044960800_ocaa266-B15","doi-asserted-by":"crossref","first-page":"e12650","DOI":"10.2196\/12650","article-title":"Use of electronic health record access and audit logs to identify physician actions following noninterruptive alert opening: descriptive study","volume":"7","author":"Amroze","year":"2019","journal-title":"JMIR Med Inform"},{"key":"2021042419044960800_ocaa266-B16","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1093\/jamia\/ocaa072","article-title":"COVID-19 transforms health care through telemedicine: evidence from the field","author":"Mann","year":"2020","journal-title":"J Am Med Inform Assoc"},{"issue":"18","key":"2021042419044960800_ocaa266-B17","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1056\/NEJMp2003539","article-title":"Virtually perfect? Telemedicine for Covid-19","volume":"382","author":"Hollander","year":"2020","journal-title":"N Engl J Med"},{"issue":"5","key":"2021042419044960800_ocaa266-B18","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1177\/1357633X20916567","article-title":"Telehealth for global emergencies: implications for coronavirus disease 2019 (COVID-19)","volume":"26","author":"Smith","year":"2020","journal-title":"J Telemed Telecare"},{"key":"2021042419044960800_ocaa266-B19","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1093\/jamia\/ocaa067","article-title":"Telehealth transformation: COVID-19 and the rise of virtual care","author":"Wosik","year":"2020","journal-title":"J Am Med Inform Assoc"},{"key":"2021042419044960800_ocaa266-B20","article-title":"Multi-center analysis of electronic health record use among ophthalmologists","author":"Baxter","year":"2020","journal-title":"Ophthalmology"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/28\/5\/955\/37334995\/ocaa266.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/28\/5\/955\/37334995\/ocaa266.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T19:08:06Z","timestamp":1619291286000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/28\/5\/955\/5992327"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,19]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,11,19]]},"published-print":{"date-parts":[[2021,4,23]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocaa266","relation":{},"ISSN":["1527-974X"],"issn-type":[{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,5,1]]},"published":{"date-parts":[[2020,11,19]]}}}