Effect of Tailored Coaching on Physicians’ Electronic Health Record Proficiency and User Experience: A Randomized Crossover Study

Abstract

Objective: To examine the effect of a tailored EHR coaching intervention, informed by audit log data, on physicians’ EHR proficiency, and user experience among pediatricians. Patients and Methods: A 12-month (August 2020 – August 2021) randomized crossover quality improvement study of a tailored EHR coaching was conducted on 34 pediatric physicians at a major medical center. Participants were randomized into Group AB or Group BA. The intervention was a single 1-hour, one-on-one coaching session. An Epic certified pediatrician tailored each coaching session to meet each physician needs using their EHR audit log data. We analyzed EHR audit log data for 3 months pre- and post-intervention. Results: Out of the 34 physicians, 15 (44%) were primary care pediatricians, 19 (56%) were female, 24 (70%) practiced at the medical center. During the initial intervention, the average proficiency score for the Group AB increased by 8.9% (pre-post difference: 0.37, 95% CI: −0.35 to 1.09; P-value=.381). For the crossover intervention, the average proficiency score for Group BA significantly increased by 11.2% (pre-post difference: 0.31, 95% CI: −0.11 to 0.74; P-value=.05). The average perceived EHR workload decreased post coaching sessions compared to pre-session (50.89 vs 46.66, P-value=.06). Post-coaching intervention, the average score for perceived EHR usability improved compared to pre-intervention (4.10 vs 4.34; P-value=.1). Conclusion: Electronic health record audit log data can be used to inform tailored coaching to improve physicians’ EHR proficiency levels and user experience. Tailored EHR coaching can increase awareness about efficiency tools available in the EHR. These findings are relevant to decisionmakers and learning health systems interested in provider well-being by optimizing EHR use.