{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T08:44:46Z","timestamp":1775810686147,"version":"3.50.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T00:00:00Z","timestamp":1617580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"2 American Medical Association Practice Transformation Initiatives","award":["36648"],"award-info":[{"award-number":["36648"]}]},{"name":"2 American Medical Association Practice Transformation Initiatives","award":["36650"],"award-info":[{"award-number":["36650"]}]},{"DOI":"10.13039\/100009457","name":"American Medical Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009457","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To derive 7 proposed core electronic health record (EHR) use metrics across 2 healthcare systems with different EHR vendor product installations and examine factors associated with EHR time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>A cross-sectional analysis of ambulatory physicians EHR use across the Yale-New Haven and MedStar Health systems was performed for August 2019 using 7 proposed core EHR use metrics normalized to 8 hours of patient scheduled time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Five out of 7 proposed metrics could be measured in a population of nonteaching, exclusively ambulatory physicians. Among 573 physicians (Yale-New Haven N\u2009=\u2009290, MedStar N\u2009=\u2009283) in the analysis, median EHR-Time8 was 5.23 hours. Gender, additional clinical hours scheduled, and certain medical specialties were associated with EHR-Time8 after adjusting for age and health system on multivariable analysis. For every 8 hours of scheduled patient time, the model predicted these differences in EHR time (P\u2009&amp;lt;\u2009.001, unless otherwise indicated): female physicians +0.58 hours; each additional clinical hour scheduled per month \u22120.01 hours; practicing cardiology \u22121.30 hours; medical subspecialties \u22120.89 hours (except gastroenterology, P\u2009=\u2009.002); neurology\/psychiatry \u22122.60 hours; obstetrics\/gynecology \u22121.88 hours; pediatrics \u22121.05 hours (P\u2009=\u2009.001); sports\/physical medicine and rehabilitation \u22123.25 hours; and surgical specialties \u22123.65 hours.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>For every 8 hours of scheduled patient time, ambulatory physicians spend more than 5 hours on the EHR. Physician gender, specialty, and number of clinical hours practicing are associated with differences in EHR time. While audit logs remain a powerful tool for understanding physician EHR use, additional transparency, granularity, and standardization of vendor-derived EHR use data definitions are still necessary to standardize EHR use measurement.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocab011","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T20:24:19Z","timestamp":1610742259000},"page":"1383-1392","source":"Crossref","is-referenced-by-count":58,"title":["Characterizing physician EHR use with vendor derived data: a feasibility study and cross-sectional analysis"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6509-9537","authenticated-orcid":false,"given":"Edward R","family":"Melnick","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA"}]},{"given":"Shawn Y","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7550-1569","authenticated-orcid":false,"given":"Allan","family":"Fong","sequence":"additional","affiliation":[{"name":"MedStar Health National Center for Human Factors in Healthcare, Washington, DC, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7955-9875","authenticated-orcid":false,"given":"Vimig","family":"Socrates","sequence":"additional","affiliation":[{"name":"Computational Biology and Bioinformatics, Yale School of Medicine, New Haven, Connecticut, USA"}]},{"given":"Raj M","family":"Ratwani","sequence":"additional","affiliation":[{"name":"MedStar Health National Center for Human Factors in Healthcare, Washington, DC, USA"}]},{"given":"Bidisha","family":"Nath","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA"}]},{"given":"Michael","family":"Simonov","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA"}]},{"given":"Anup","family":"Salgia","sequence":"additional","affiliation":[{"name":"Northeast Ohio Medical University and Cerner Corporation, Kansas City, Missouri, USA"}]},{"given":"Brian","family":"Williams","sequence":"additional","affiliation":[{"name":"Northeast Medical Group, Yale-New Haven Health, Stratford, Connecticut, USA"}]},{"given":"Daniel","family":"Marchalik","sequence":"additional","affiliation":[{"name":"Department of Urology, MedStar Health, Washington, DC, USA"}]},{"given":"Richard","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Northeast Medical Group, Yale-New Haven Health, Stratford, Connecticut, USA"}]},{"given":"Christine A","family":"Sinsky","sequence":"additional","affiliation":[{"name":"Professional Satisfaction and Practice Sustainability, 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