Journal article
EHR-Driven Delivery of EPA Assessments Significantly fi cantly Improves Participation
Journal of surgical education, Vol.81(11), pp.A12-A22
11/01/2024
DOI: 10.1016/j.jsurg.2024.06.015
PMID: 38964960
Abstract
INTRODUCTION: Digital education tools are a cornerstone in the evolution to CBME through EPAs. Successful implementation requires understanding the variable impacts of EHR-driven delivery of EPAs, flexible digital device access to EPAs, and user-behavior trends. METHODS: Through a HIPAA compliant, flexible-device accessible, surgical education platform, general surgery training programs at 21 institutions collected EPA from July 2023 to April 2024. At 5 EHR-integrated institutions (EHR+), EPA were created for clinical activities based on the OR schedule, automatically pushed to attendings and residents with built in completion reminders. At 16 institutions without EHR integration (EHR-), EPA were initiated manually. To improve user experience, care phases were bundled (cEPA). We compared the EHR+ and EHR-- groups, computing descriptive statistics on the cEPAs completed and user behavior metrics. RESULTS: We collected 4187 cEPAs in total, with 82% at EHR+ institutions and 18% at EHR- institutions. Platform triggering dramatically drove cEPA completion for both faculty and residents, 88% and 81%, respectively. Only 3% were initiated by the faculty or resident. Faculty at EHR+ institutions strongly preferred the automated OR- triggered workflow to start their EPAs (Chi-squared test, p 0). Faculty completed all 3 care phases nearly 80% of the time. Time reminders specifically drive EPA completion for residents and faculty on weekdays and build habits on weekends. 71% of cEPAs completed were by computer, and 29% by phone. More comments were provided when computers were used. Residents reviewed feedback with a median lag of 1 hour and 29 min after results were available. CONCLUSIONS: EHR-driven delivery of EPA leads to a 4.6-fold increase in EPAs completed. EPA initiation is the most critical phase in the workflow and EHR-data driven alerts drive this action. These alerts are also effective drivers of habit formation. Flexible device access is important to increase EPAs completed and improve the usefulness through comments for residents. ( J Surg Ed 81:A12- A22. (c) 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)
Details
- Title: Subtitle
- EHR-Driven Delivery of EPA Assessments Significantly fi cantly Improves Participation
- Creators
- Carolyn Chang - Decision SciencesJonathan Jesneck - Firefly Fdn & Firefly Lab, Lake Oswego, OR USAEmily Lee - University of PortlandKaren Brasel - University of PortlandMackenzie Cook - University of PortlandRamanathan Seshadri - Danbury HospitalJames Nitzkorski - Vassar Brothers Medical CenterRebecca Rhee - Maimonides Medical CenterJulia Shelton - University of IowaRuchi Thanawala - Decision Sciences
- Resource Type
- Journal article
- Publication Details
- Journal of surgical education, Vol.81(11), pp.A12-A22
- Publisher
- Elsevier
- DOI
- 10.1016/j.jsurg.2024.06.015
- PMID
- 38964960
- ISSN
- 1931-7204
- eISSN
- 1878-7452
- Number of pages
- 11
- Language
- English
- Date published
- 11/01/2024
- Academic Unit
- Stead Family Department of Pediatrics; Surgery
- Record Identifier
- 9984740957002771
Metrics
2 Record Views