PMID- 37812421 OWN - NLM STAT- MEDLINE DCOM- 20231206 LR - 20231206 IS - 2574-3805 (Electronic) IS - 2574-3805 (Linking) VI - 6 IP - 10 DP - 2023 Oct 2 TI - Differences in Health Professionals' Engagement With Electronic Health Records Based on Inpatient Race and Ethnicity. PG - e2336383 LID - 10.1001/jamanetworkopen.2023.36383 [doi] LID - e2336383 AB - IMPORTANCE: US health professionals devote a large amount of effort to engaging with patients' electronic health records (EHRs) to deliver care. It is unknown whether patients with different racial and ethnic backgrounds receive equal EHR engagement. OBJECTIVE: To investigate whether there are differences in the level of health professionals' EHR engagement for hospitalized patients according to race or ethnicity during inpatient care. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study analyzed EHR access log data from 2 major medical institutions, Vanderbilt University Medical Center (VUMC) and Northwestern Medicine (NW Medicine), over a 3-year period from January 1, 2018, to December 31, 2020. The study included all adult patients (aged >/=18 years) who were discharged alive after hospitalization for at least 24 hours. The data were analyzed between August 15, 2022, and March 15, 2023. EXPOSURES: The actions of health professionals in each patient's EHR were based on EHR access log data. Covariates included patients' demographic information, socioeconomic characteristics, and comorbidities. MAIN OUTCOMES AND MEASURES: The primary outcome was the quantity of EHR engagement, as defined by the average number of EHR actions performed by health professionals within a patient's EHR per hour during the patient's hospital stay. Proportional odds logistic regression was applied based on outcome quartiles. RESULTS: A total of 243 416 adult patients were included from VUMC (mean [SD] age, 51.7 [19.2] years; 54.9% female and 45.1% male; 14.8% Black, 4.9% Hispanic, 77.7% White, and 2.6% other races and ethnicities) and NW Medicine (mean [SD] age, 52.8 [20.6] years; 65.2% female and 34.8% male; 11.7% Black, 12.1% Hispanic, 69.2% White, and 7.0% other races and ethnicities). When combining Black, Hispanic, or other race and ethnicity patients into 1 group, these patients were significantly less likely to receive a higher amount of EHR engagement compared with White patients (adjusted odds ratios, 0.86 [95% CI, 0.83-0.88; P < .001] for VUMC and 0.90 [95% CI, 0.88-0.92; P < .001] for NW Medicine). However, a reduction in this difference was observed from 2018 to 2020. CONCLUSIONS AND RELEVANCE: In this cross-sectional study of inpatient EHR engagement, the findings highlight differences in how health professionals distribute their efforts to patients' EHRs, as well as a method to measure these differences. Further investigations are needed to determine whether and how EHR engagement differences are correlated with health care outcomes. FAU - Yan, Chao AU - Yan C AD - Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee. FAU - Zhang, Xinmeng AU - Zhang X AD - Department of Computer Science, Vanderbilt University, Nashville, Tennessee. FAU - Yang, Yuyang AU - Yang Y AD - Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Kang, Kaidi AU - Kang K AD - Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee. FAU - Were, Martin C AU - Were MC AD - Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee. FAU - Embi, Peter AU - Embi P AD - Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee. FAU - Patel, Mayur B AU - Patel MB AD - Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, Tennessee. AD - Geriatric Research and Education Clinical Center, Veterans Affairs, Tennessee Valley Healthcare System, Nashville. AD - Division of Acute Care Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee. AD - Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee. FAU - Malin, Bradley A AU - Malin BA AD - Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee. AD - Department of Computer Science, Vanderbilt University, Nashville, Tennessee. AD - Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee. FAU - Kho, Abel N AU - Kho AN AD - Feinberg School of Medicine, Northwestern University, Chicago, Illinois. AD - Institute for Public Health and Medicine, Northwestern University, Chicago, Illinois. AD - Department of Medicine-General Internal Medicine, Northwestern University, Chicago, Illinois. FAU - Chen, You AU - Chen Y AD - Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee. AD - Department of Computer Science, Vanderbilt University, Nashville, Tennessee. LA - eng PT - Journal Article DEP - 20231002 PL - United States TA - JAMA Netw Open JT - JAMA network open JID - 101729235 SB - IM CIN - JAMA Netw Open. 2023 Oct 2;6(10):e2336336. PMID: 37812423 MH - Adult MH - Female MH - Humans MH - Male MH - Middle Aged MH - Black or African American MH - Cross-Sectional Studies MH - *Electronic Health Records/statistics & numerical data MH - *Ethnicity MH - White MH - Hospitalization/statistics & numerical data MH - Attitude of Health Personnel MH - Aged MH - *Healthcare Disparities/ethnology/statistics & numerical data MH - Time Factors PMC - PMC10562942 COIS- Conflict of Interest Disclosures: Dr Patel reported receiving grant support as Vanderbilt University Medical Center Ingram Chair in Surgical Sciences during the conduct of the study and grants from the National Institutes of Health and US Department of Defense, board of directors travel support from EAST, Trauma and Prothrombin Complex Concentrate Study support from CSL Behring, personal fees from Elsevier, and device support from Haemonetics outside the submitted work. Dr Kho reported receiving personal fees from Datavant outside the submitted work. No other disclosures were reported. EDAT- 2023/10/09 12:42 MHDA- 2023/11/01 12:42 PMCR- 2023/10/09 CRDT- 2023/10/09 11:33 PHST- 2023/11/01 12:42 [medline] PHST- 2023/10/09 12:42 [pubmed] PHST- 2023/10/09 11:33 [entrez] PHST- 2023/10/09 00:00 [pmc-release] AID - 2810366 [pii] AID - zoi231047 [pii] AID - 10.1001/jamanetworkopen.2023.36383 [doi] PST - epublish SO - JAMA Netw Open. 2023 Oct 2;6(10):e2336383. doi: 10.1001/jamanetworkopen.2023.36383.