Grant: Catalyst Grant: Quadruple Aim and Equity

Electronic Health Records (EHRs) systems are used for viewing (e.g. laboratory or test results), documenting (e.g., entering data and notes), ordering (e.g., referrals, prescriptions, tests), messaging (e.g., notifying patients of test results), care management (e.g., disease-specific tools, allergies), analysis and reporting. These systems also have patient-directed capabilities and allow for patients to access to own lab values and message care providers. While these EHR capabilities are intended to be drivers of health transformation, they often lead to unintended negative consequences such as patient safety issues, communication issues, burnout, and other adverse issues for providers. Existing data on these implications are predominantly from the US, with more documentation requirements than Canada. In order to understand the Canadian landscape, this study aims to measure the extent of the use of an EHR by specialists (nephrologists, surgeons, and cardiologists) in Alberta. Data from the first eight months from the EHR will be retrieved for each specialist. For each specialist, specialist group and all specialists combined, the data will be analyzed to determine the actual time spent on specific activities, time spent switching between activities, time spent on care coordination, and time spent on direct patient care. This project is led by a multi-disciplinary research team comprised of decision-makers and researchers who developed this study. Senior staff from AHS and the unit heads from the participating departments will be continually involved in any research-related decision-making and have immediate and direct access to the team's outputs. Each specialist will receive a summary of their EHR usage patterns over the reporting period compared to the overall usage patterns of all specialists (audit and feedback approach). The audit and feedback approach will allow each specialist to visualize their EHR routines compared to their peers (quality improvement).