Browsing by Author "Thompson, Lindsay A."

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    A novel method for evaluating physician communication: A pilot study testing the feasibility of parent-assisted audio recordings via Zoom
    (Elsevier, 2022) Staras, Stephanie A. S.; Bylund, Carma L.; Desai, Shivani; Harle, Christopher A.; Richardson, Eric; Khalil, Georges E.; Thompson, Lindsay A.; Health Policy and Management, Richard M. Fairbanks School of Public Health
    Objective: Quality of physician consultations are best assessed via direct observation, but require intensive in-clinic research staffing. To evaluate physician consultation quality remotely, we pilot tested the feasibility of parents using their personal mobile phones to facilitate audio recordings of pediatric visits. Methods: Across four academic pediatric primary care clinics, we invited all physicians with a patient panel (n=20). For participating physicians, we identified scheduled patients from medical records. We invited parents to participate via text message and phone calls. During their adolescent's appointment, parents used their mobile phone to connect to Zoom for remote research staff to audio record. Results: In Spring 2021, five of 20 (25%) physicians participated. During a nine-week period, we invited parents of all 54 patients seen by participating physicians of which 15 (28%) completed adult consent and adolescent assent and 10 (19%) participated. For 9 recordings, at least 45% of the conversation was audible. Conclusions: It was feasible and acceptable to directly observe physician consultations virtually with Zoom, although participation rates and potentially audio quality were lower. Innovation: Patients used their cellular phone calling features to connect to Zoom where research staff audio-recorded their physician consultation to evaluate communication quality.
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    Disparities in Pediatric Patient Portal Activation and Feature Us
    (Oxford University Press, 2021-09-29) LeLaurin, Jennifer H.; Nguyen, Oliver T.; Thompson, Lindsay A.; Hall, Jaclyn; Bian, Jiang; Cho, Hee Deok; Acharya, Ratna; Harle, Christopher A.; Salloum, Ramzi G.; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health
    Objective: Disparities in adult patient portal adoption are well-documented; however, less is known about disparities in portal adoption in pediatrics. This study examines the prevalence and factors associated with patient portal activation and the use of specific portal features in general pediatrics. Materials and methods: We analyzed electronic health record data from 2012 to 2020 in a large academic medical center that offers both parent and adolescent portals. We summarized portal activation and use of select portal features (messaging, records access and management, appointment management, visit/admissions summaries, and interactive feature use). We used logistic regression to model factors associated with patient portal activation among all patients along with feature use and frequent feature use among ever users (ie, ≥1 portal use). Results: Among 52 713 unique patients, 39% had activated the patient portal, including 36% of patients aged 0-11, 41% of patients aged 12-17, and 62% of patients aged 18-21 years. Among activated accounts, ever use of specific features ranged from 28% for visit/admission summaries to 92% for records access and management. Adjusted analyses showed patients with activated accounts were more likely to be adolescents or young adults, white, female, privately insured, and less socioeconomically vulnerable. Individual feature use among ever users generally followed the same pattern. Conclusions: Our findings demonstrate that important disparities persist in portal adoption in pediatric populations, highlighting the need for strategies to promote equitable access to patient portals.
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    Primary care physicians’ electronic health record proficiency and efficiency behaviors and time interacting with electronic health records: a quantile regression analysis
    (Oxford University Press, 2022) Nguyen, Oliver T.; Turner, Kea; Apathy, Nate C.; Magoc, Tanja; Hanna, Karim; Merlo, Lisa J.; Harle, Christopher A.; Thompson, Lindsay A.; Berner, Eta S.; Feldman, Sue S.; Health Policy and Management, Richard M. Fairbanks School of Public Health
    Objective: This study aimed to understand the association between primary care physician (PCP) proficiency with the electronic health record (EHR) system and time spent interacting with the EHR. Materials and methods: We examined the use of EHR proficiency tools among PCPs at one large academic health system using EHR-derived measures of clinician EHR proficiency and efficiency. Our main predictors were the use of EHR proficiency tools and our outcomes focused on 4 measures assessing time spent in the EHR: (1) total time spent interacting with the EHR, (2) time spent outside scheduled clinical hours, (3) time spent documenting, and (4) time spent on inbox management. We conducted multivariable quantile regression models with fixed effects for physician-level factors and time in order to identify factors that were independently associated with time spent in the EHR. Results: Across 441 primary care physicians, we found mixed associations between certain EHR proficiency behaviors and time spent in the EHR. Across EHR activities studied, QuickActions, SmartPhrases, and documentation length were positively associated with increased time spent in the EHR. Models also showed a greater amount of help from team members in note writing was associated with less time spent in the EHR and documenting. Discussion: Examining the prevalence of EHR proficiency behaviors may suggest targeted areas for initial and ongoing EHR training. Although documentation behaviors are key areas for training, team-based models for documentation and inbox management require further study. Conclusions: A nuanced association exists between physician EHR proficiency and time spent in the EHR.