Sponsor: The Gordon and Betty Moore Foundation

The digitization of health records and the metadata captured by these systems create a novel and exciting opportunity to rapidly advance our understanding of the diagnostic process and diagnostic excellence. Specifically, the ability to truly understand how frontline clinicians interact with clinical information when making diagnostic decisions, and how these interactions impact diagnostic quality, may be greatly improved by analysis of a largely-unused, highly-granular level of electronic health record (EHR) data (referred to as “audit log” data) that are captured primarily for administrative compliance purposes today. This grant to the University of California, San Francisco Office of Sponsored Research (UCSF) will leverage the use of audit log data to capture contextual dimensions of diagnostic assessment (including clinical decision-making, clinical team structure and clinical processes) from three health systems (UCSF, Stanford and Kaiser Permanente Northern California). By identifying key contextual factors that contribute to diagnostic performance, this work may ultimately improve the efficiency of diagnostic processes and reduce errors.

Sponsor: The American Medical Association

To reduce EHR documentation burden, CMS changed documentation requirements for E&M encounters, with large-scale changes going into effect in 2021. The goal of this project is to conduct a comprehensive assessment of the impact of these changes on EHR time, EHR use patterns, and physician burnout. We will partner with Cerner to assess changes in a national sample and complement this with a deep dive into the experiences of UCSF physicians, including assessment of changes in validated measures of burnout.