Outcomes of an Advanced Epic Personalization Course on Clinician Efficiency through Use of Electronic Medical Records: Retrospective Study.

Background: Since Singapore's first migration to Epic in 2022, we have been conducting an advanced Epic personalization course twice a year for health care professionals with at least 3 months of experience using the system. Electronic medical records education is an under-recognized pillar in reducing health information technology-related stress and clinician burnout.

Objective: The intent of the course is to improve clinician efficiency through customization and personalization of Epic interfaces. We hypothesized that compared to their colleagues, trained clinicians would demonstrate significant quantitative improvements in use of the Epic system after our course.

Methods: We performed a retrospective analysis from July 2022 to January 2024, including 17 clinicians among 77 individuals who attended our course. Recruitment was done through digital mailers sent out via the local hospital announcement channels. Interested clinicians were able to register for our course via the National University Of Singapore website. Our one-day course involves physical lessons and interprofessional, case-based discussions emphasizing a wide range of high-yield Epic functionalities with practice exercises, such as drafting referral letter templates. Three months of pre- and postcourse Epic usage statistics of the trained clinicians were retrieved based on aggregate data provided by Epic Singapore. Performance metrics included documentation length, time spent in Epic functionalities and use of SmartPhrases, order sets and preference lists.

Results: At three months post-course, documentation length decreased by 45.8% (711.8 characters) compared to a 22.2% (126.4 characters) increase among controls. Trained clinicians demonstrated a 2.47-fold increase in use of order sets from 16.2% to 40%, and a 49.9% increase in orders from preference lists after the course, from 35.1% to 52.6%. In total, trained clinicians demonstrated a 1.8-fold increase in combined use of orders from preference lists or order sets after the course, from 51.4% to 92.6%. The number of SmartPhrases created by trained clinicians was 5.64 times higher than among controls, in addition to a 5.57-fold higher use of Quick Filters than controls. Moreover, time in the Chart Review section per day decreased by 29.3% (4.6 min) among trained clinicians versus an increase of 14.6% (2.8 min) among controls. Compared to controls, trained clinicians spent 36.7% (219.6 min) less time in the Epic system per day, 56.6% (29 min) less time on Notes per day, and 57.5% (10.7 min) less time on orders per day.

Conclusions: Overall, trained clinicians demonstrated more efficiency in their use of Epic, with reduced time spent across various functionalities. Increased use of Smart Tools, including SmartPhrases and Quick Filters was also observed among trained clinicians, which indicated efficiency in reducing total usage time. These findings demonstrated broad improvements across multiple physician efficiency metrics among participating clinicians of our advanced Epic personalization course. These gains may contribute to improved mental health among health care professionals and enhanced productivity within health care systems.