Accuracy of Physician Electronic Health Record Usage Analytics using Clinical Test Cases
Bibliographic record
Abstract
Usage log data are an important data source for characterizing the potential burden related to use of the electronic health record (EHR) system. However, the utility of this data source has been hindered by concerns related to the real-world validity and accuracy of the data. While time-motion studies have historically been used to address this concern, the restrictions caused by the pandemic have made it difficult to carry out these studies in-person. In this regard, we introduce a practical approach for conducting validation studies for usage log data in a controlled environment. By developing test runs based on clinical workflows and conducting them within a test EHR environment, it allows for both comparison of the recorded timings and retrospective investigation of any discrepancies. In this case report, we describe the utility of this approach for validating our physician EHR usage logs at a large academic teaching mental health hospital in Canada. A total of 10 test runs were conducted across 3 days to validate 8 EHR usage log metrics, finding differences between recorded measurements and the usage analytics platform ranging from 9 to 60%.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.035 | 0.246 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".