Publications by authors named "David McCallie"

5 Publications

  • Page 1 of 1

Physician Time Spent Using the Electronic Health Record During Outpatient Encounters.

Ann Intern Med 2020 10;173(7):594-595

Cerner Corporation, Kansas City, Missouri (D.M.).

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http://dx.doi.org/10.7326/L20-0278DOI Listing
October 2020

Physician Time Spent Using the Electronic Health Record During Outpatient Encounters: A Descriptive Study.

Ann Intern Med 2020 02 14;172(3):169-174. Epub 2020 Jan 14.

Cerner Corporation, Kansas City, Missouri (J.M.O., D.M.).

Background: The amount of time that providers spend using electronic health records (EHRs) to support the care delivery process is a concern for the U.S. health care system. Given the potential effect on patient care and the high costs related to this time, particularly for medical specialists whose work is largely cognitive, these findings warrant more precise documentation of the time physicians invest in these clinically focused EHR functions.

Objective: To describe how much time ambulatory medical subspecialists and primary care physicians across several U.S. care delivery systems spend on various EHR functions.

Design: Descriptive study.

Setting: U.S.-based, adult, nonsurgical, ambulatory practices using the Cerner Millennium EHR.

Participants: 155 000 U.S. physicians.

Measurements: Data were extracted from software log files in the Lights On Network (Cerner) during 2018 that totaled the time spent on each of the 13 clinically focused EHR functions. Averages per encounter by specialty were computed.

Results: This study included data from approximately 100 million patient encounters with about 155 000 physicians from 417 health systems. Physicians spent an average of 16 minutes and 14 seconds per encounter using EHRs, with chart review (33%), documentation (24%), and ordering (17%) functions accounting for most of the time. The distribution of time spent by providers using EHRs varies greatly within specialty. The proportion of time spent on various clinically focused functions was similar across specialties.

Limitation: Variation by health system could not be examined, and all providers used the same software.

Conclusion: The time spent using EHRs to support care delivery constitutes a large portion of the physicians' day, and wide variation suggests opportunities to optimize systems and processes.

Primary Funding Source: None.
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http://dx.doi.org/10.7326/M18-3684DOI Listing
February 2020

Finding a Place for Pharmacogenetics in the Electronic Health Record.

Clin Pharmacol Ther 2019 08 25;106(2):295-297. Epub 2019 Jun 25.

Cerner Corporation, Kansas City, Missouri, USA.

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http://dx.doi.org/10.1002/cpt.1504DOI Listing
August 2019

Report of the AMIA EHR-2020 Task Force on the status and future direction of EHRs.

J Am Med Inform Assoc 2015 Sep 28;22(5):1102-10. Epub 2015 May 28.

Sparrow Health System, Lansing, MI and Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA.

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http://dx.doi.org/10.1093/jamia/ocv066DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5009932PMC
September 2015

An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY Challenge.

Genome Biol 2014 Mar 25;15(3):R53. Epub 2014 Mar 25.

Background: There is tremendous potential for genome sequencing to improve clinical diagnosis and care once it becomes routinely accessible, but this will require formalizing research methods into clinical best practices in the areas of sequence data generation, analysis, interpretation and reporting. The CLARITY Challenge was designed to spur convergence in methods for diagnosing genetic disease starting from clinical case history and genome sequencing data. DNA samples were obtained from three families with heritable genetic disorders and genomic sequence data were donated by sequencing platform vendors. The challenge was to analyze and interpret these data with the goals of identifying disease-causing variants and reporting the findings in a clinically useful format. Participating contestant groups were solicited broadly, and an independent panel of judges evaluated their performance.

Results: A total of 30 international groups were engaged. The entries reveal a general convergence of practices on most elements of the analysis and interpretation process. However, even given this commonality of approach, only two groups identified the consensus candidate variants in all disease cases, demonstrating a need for consistent fine-tuning of the generally accepted methods. There was greater diversity of the final clinical report content and in the patient consenting process, demonstrating that these areas require additional exploration and standardization.

Conclusions: The CLARITY Challenge provides a comprehensive assessment of current practices for using genome sequencing to diagnose and report genetic diseases. There is remarkable convergence in bioinformatic techniques, but medical interpretation and reporting are areas that require further development by many groups.
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http://dx.doi.org/10.1186/gb-2014-15-3-r53DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073084PMC
March 2014
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