Lawrence Marks, MD, and Lukasz M. Mazur, PhD

A study led by University of North Carolina Lineberger Comprehensive Cancer Center researchers examined the impact of electronic health records (EHR) on physician work load and performance in managing critical or abnormal test results.

Lukasz M. Mazur, PhD, an associate professor in the UNC School of Medicine Department of Radiation Oncology, and UNC Lineberger’s Lawrence Marks, MD, chair of the Department of Radiation Oncology and the Dr. Sidney K. Simon Distinguished Professor of Oncology Research, co-authored the study, which was published in JAMA Network Open.

“In this study, relatively simple improvements improved performance, showing that we can make meaningful changes to the EHR to improve providers’ lives and their performance,” Marks said.

The study tested the impact of an enhancement in the EHR on providers’ ability to manage abnormal test results that provided decision support instructions for abnormal results. In a simulation run between April 1, 2016 and Dec. 23, 2016, resident and fellows used the enhanced or basic EHR. Researchers studied the users’ performance and workload, and also their ability to follow-up on abnormal or critical test results.

The study found that EHR enhancements were linked to better physician workload and performance.

“Usability improvements in electronic health records appear to be associated with improved cognitive workload and performance levels among clinicians; this finding suggests that next-generation systems should strip away non–value-added interactions,” Mazur said.

Mazur added that he hopes the study motivates others request or demand “more positive usability changes within EHRs.”

“Providers should not passively accept the sub-optimal workflow environments within EHRs,” he said.

Mazur and his collaborators have been doing quality-related research as part of the Division of Healthcare Engineering with the Department of Radiation Oncology. While most work has been related to quality in radiation oncology, the recent study reflects a broader scope of their effort, Marks said.

In addition to Marks and Mazur, other authors include: Prithima R. Mosaly, PhD, and Carlton Moore, MD.

Marks has received grants from Elekta, Accuray, Community Health, and the U.S. government during the conduct of the study, as well as possible royalties for him, his department, and its members from a software patent.

The study was supported by grant from the Agency for Healthcare Research and Quality.