ABSTRACT
Objective: To quantify how long neurologists spend in the electronic health record (EHR). Background: Neurologists have extensive information needs for decision-making (e.g., neuroimaging, video-recordings) that are likely to affect time spent in the EHR. While EHRrelated burden is being increasingly studied due to the national spotlight on physician burnout, few studies have focused on neurology. Design/Methods: Data were obtained using Epic Signal, which provides detailed data on how long clinicians spent on different EHR interfaces. We focused on all neurologists from an academic health system in Florida who practiced during November 2019 to October 2020 inclusive. Our EHR outcome measures were time spent interacting with the EHR, time spent in the EHR outside scheduled clinic hours, inbox management, writing notes, and chart review. We reported the median and range of outcome measures because they had skewed distributions. We also assessed whether changes related to the coronavirus pandemic (e.g., telemedicine adoption) were associated with differences in EHR use via Wilcoxon signed-rank tests. Results: Our sample contained 2,286 physician-week observations (83 neurologists). They spent up to: 333.6 minutes/day (median:66.5, range:0.5-333.6) interacting with the EHR, 303.4 minutes/day (median:27.8, range:0.0-303.4) in the EHR outside scheduled hours, 45.6 minutes/day (median:3.4, range:0.0-45.6) in the In Basket, 240.3 minutes/day (median:31.1, range:0.0-240.3) writing notes, and 73.1 minutes/day (median:11.0, range:0.0-73.1) in clinical review. EHR measures were comparable before and during the pandemic. Conclusions: Similar to physicians in other specialties, neurologists spend a significant proportion of their clinical effort engaged with the EHR. Neurologists may benefit from interventions that reduce time spent in the EHR, such as after-hours EHR use and documentation.
ABSTRACT
Objective: To explore the impact of social media behaviors in adolescents with tic disorders. Background: Social media has an increasing role in disseminating information and driving perceptions of disease. During the COVID-19 pandemic, social media consumption greatly increased, particularly in adolescent populations. In parallel, there has been an increase in tic severity and explosive tic-like disorders. Design/Methods: Adolescent patients with tics (ages 11-21) completed a 5-point Likert scale survey examining the value of various social media resources regarding their knowledge of tics. The survey also examined time spent on social media, tic frequency, tic severity, and quality of life (QOL) using a Patient Global Impressions of Change scale. Pearson correlation coefficient was used for statistical analysis. Results: Of the survey participants (N=20), 65% reported using social media at least 4-5 times per day (5.6 hours on average per day) and 90% reported increased use of social media during COVID. Only 5% of participants reported using social media for information or interactions regarding tics. Although 85% of respondents indicated that tic frequency worsened during COVID and 50% of respondents indicated that social media adversely impacted their tics, there was no significant correlation between social media use and self-reported frequency of tics at the time of the survey (R = -0.249, p = 0.289) or since the onset of COVID (R = -0.0055, p = 0.982). However, there was a statistically significant correlation between tic severity, QOL, and social media use during COVID (R = -0.496, -0.447, p = 0.026, 0.048, respectively). Conclusions: Social media use was frequent among surveyed adolescents with tics, and despite reports of limited tic-related social media use, we detected a significant correlation between tic severity and reduced QOL with increased social media use during COVID. We expect to enroll an additional 60 participants to further explore these associations.