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69% of Hospitals Can Access Clinical Documentation Measures from EHR Vendors

Critical access hospitals are less likely to have access to clinical documentation measures from their EHR vendors than their higher-resourced counterparts.

The percentage of smaller EHR vendors providing access to clinical documentation measures has increased in recent years, according to a study published in AJMC.

Researchers analyzed four waves of a nationally representative survey of over 10,000 nonfederal acute care hospitals from 2017 and 2021.

Until recently, companies with a large market share have been the primary creators of tools for clinical documentation time measures. However, the percentage of smaller EHR vendors providing these tools to their customers doubled between 2017 and 2021.

“This has translated to hospitals with fewer resources—which are more likely to use smaller developers—having increased access to these measures over time,” the study authors wrote.

However, the disparity in the availability of measures between small, critical access, rural, and independent hospitals and their higher-resourced counterparts has remained the same.

Lower-resourced hospitals were consistently less likely to track or use EHR documentation time measures than their larger, urban counterparts. The authors suggested that the gap in measure availability may be partially due to their use of non–market-leading EHR vendors.

“Thus, although the availability of measures grew at a higher rate among hospitals using products from smaller EHR developers, these developers may continue to lag in their ability to provide hospitals access to these measures,” the researchers wrote.

The authors suggested that greater use of advanced data standards may make it easier for non–market-leading EHR companies to create clinical documentation time measures for customers.

Currently, EHR vendors are not required to conform to data standards for developing and implementing audit logs for use in health IT systems.

“However, as the use of these more advanced standards for audit logs increases, leveraging audit log data for secondary purposes—such as the development of tools for tracking documentation time and optimizing EHRs—should become simpler,” the study authors said.

“Such advancements may enable non–market-leading developers to generate and make these types of tools more accessible to their clients, including hospitals with fewer resources that are more likely to be using smaller developers,” they added.

Increased client demand for clinical documentation time measures may ultimately drive smaller EHR vendors to offer such tools.

The increased utilization of these measures over time suggests there is value to hospitals in having this data available. For instance, between 2017 and 2021, there was a significant increase in hospitals’ use of EHR documentation time measures for purposes associated with enhancing efficiency. There was also a greater use of measures for clinician burden reduction initiatives.

“Developing specific strategies to support the use of EHR documentation measures is critical to enabling lower-resourced hospitals to take full advantage of these tools,” the researchers explained.

However, they emphasized that increasing the availability of such measures may not be sufficient for enabling EHR optimization.

“Hospitals may be slow to implement changes required to make use of such measures or lack the necessary resources to do so,” they wrote. “Future qualitative work could examine hospitals’ experiences with applying these measures to inform the development of best practices for those in need of support.”  

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