Using Audit Log Data to Assess EHR Burden

02/07/2020

Electronic health records (EHRs) have been widely adopted in the United States, but there is growing concern that they have unintentionally burdened clinicians, inhibiting their ability to deliver health care efficiently and effectively. In response to these concerns, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) contracted with Mathematica to examine the feasibility of leveraging EHR audit log data to measure clinician burden associated with administrative, clinical documentation, and clinical review tasks.

Mathematica examined peer-reviewed and gray literature, spoke with subject matter experts (SMEs), and convened a Technical Expert Panel (TEP) to answer the following three specific research questions: 1. Does evidence exist that EHR audit log data can be compared across disparate systems when seeking to measure clinician burden?; 2. Are there common features across audit log data that might be leveraged for national reporting of physician/clinician burden from the currently installed EHR base? 3. Can these measures be implemented and collected in a manner that allows the U.S. Department of Health and Human Services (HHS) to measure changes in burden over time?

This is the last in a series of four iterative reports, adding supplemental literature and interviews with two SMEs to prior analyses. This final report also incorporates feedback from the project’s second TEP meeting.

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