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Objective: To examine the effect of a tailored EHR coaching intervention, informed by audit log data, on physicians’ EHR proficiency, and user experience among pediatricians. Patients and Methods: A 12-month (August 2020 – August 2021) randomized crossover quality improvement study of a tailored EHR coaching was conducted on 34 pediatric physicians at a major medical center. Participants were randomized into Group AB or Group BA. The intervention was a single 1-hour, one-on-one coaching session. An Epic certified pediatrician tailored each coaching session to meet each physician needs using their EHR audit log data. We analyzed EHR audit log data for 3 months pre- and post-intervention. Results: Out of the 34 physicians, 15 (44%) were primary care pediatricians, 19 (56%) were female, 24 (70%) practiced at the medical center. During the initial intervention, the average proficiency score for the Group AB increased by 8.9% (pre-post difference: 0.37, 95% CI: −0.35 to 1.09; P-value=.381). For the crossover intervention, the average proficiency score for Group BA significantly increased by 11.2% (pre-post difference: 0.31, 95% CI: −0.11 to 0.74; P-value=.05). The average perceived EHR workload decreased post coaching sessions compared to pre-session (50.89 vs 46.66, P-value=.06). Post-coaching intervention, the average score for perceived EHR usability improved compared to pre-intervention (4.10 vs 4.34; P-value=.1). Conclusion: Electronic health record audit log data can be used to inform tailored coaching to improve physicians’ EHR proficiency levels and user experience. Tailored EHR coaching can increase awareness about efficiency tools available in the EHR. These findings are relevant to decisionmakers and learning health systems interested in provider well-being by optimizing EHR use.

More than 1.2 million adults are incarcerated in the United States and hence, require health care from prison systems. The current delivery of care to incarcerated individualss is expensive, logistically challenging, risk fragmenting care, and pose security risks. The purpose of this study was to evaluate the association of patient characteristics and experiences with the perceived telemedicine experiences of incarcerated individuals during the pandemic. We conducted a cross-sectional study of incarcerated individuals in 55 North Carolina prison facilities seeking medical specialty care via telemedicine. Data collection took place from June 1, 2020 to November 30, 2020. Of the 482 patient surveys completed, 424 (88%) were male, 257 (53.3%) were over 50 years of age, and 225 (46.7%) were Black or African American and 195 (40.5%) were White, and 289 (60%) no prior telemedicine experience. There were 3 strong predictors of how patients rated their telemedicine experience: personal comfort with telemedicine ( P -value < .001), wait time ( P -value < .001), and the clarity of the treatment explanation by the provider ( P -value < .001). There was a relationship between telemedicine experiences and how patient rated their experience. Also, patients who were less satisfied with using telemedicine indicated their preference for an in-clinic visit for their next appointment.

Urgent care (UC) is one of the fastest growing venues of health care delivery for nonemergent conditions. This study compared the patient experience during virtual and in-person urgent care visits. We conducted a cross-sectional study of patients with the same diagnosis during Virtual Urgent Care (VUC) and in-person UC visits with the same diagnosis with regard to time and cost over a period of one year. We recorded and analyzed 16 685 urgent care visits: In-person UC (n = 14 734), VUC (n = 1262). Significant differences were found in the average total time for a visit in an in-person UC (70.89 minutes), and VUC (9.38 minutes). The average total cost of VUC ($49) and in-person UC ($142.657) differed significantly. Significant difference was found between UC turnaround time and VC turnaround time (Dependent variable (DV): 53.77, P < .01). We found significant differences in cost and time between in favor of virtual visits. Our findings suggest additional policy reform to expand the use of virtual care among target populations to improve access, reduce costs, meet the needs of patients, and reduce emergency department visits.

Positive patient experiences are associated with illness recovery and adherence to medication. To evaluate the virtual care experience for patients with COVID-19 symptoms as their chief complaints. We conducted a cross-sectional study of the first cohort of patients with COVID-19 symptoms in a virtual clinic. The main end points of this study were visit volume, wait times, visit duration, patient diagnosis, prescriptions received, and satisfaction. Of the 1139 total virtual visits, 212 (24.6%) patients had COVID-19 symptoms. The average wait time (SD) for all visits was 75.5 (121.6) minutes. The average visit duration for visits was 10.5 (4.9) minutes. The highest volume of virtual visits was on Saturdays (39), and the lowest volume was on Friday (19). Patients experienced shorter wait times (SD) on the weekdays 67.1 (106.8) minutes compared to 90.3 (142.6) minutes on the weekends. The most common diagnoses for patients with COVID-19 symptoms were upper respiratory infection. Patient wait times for a telehealth visit varied depending on the time and day of appointment. Long wait times were a major drawback in the patient experience. Based on patient-reported experience, we proposed a list of general, provider, and patient telehealth best practices.

Abstract: During the COVID-19 pandemic, telehealth utilization grew astronomically, encouraging more institutions of higher education to become innovative and proactive in preparing health care providers to deliver high-quality telehealth care. Telehealth can be creatively implemented throughout health care curricula given the appropriate guidance and tools. This article speaks to the development of student telehealth projects as part of the work of a national taskforce funded by the Health Resources and Services Administration and charged with the development of a telehealth toolkit. Proposed telehealth projects allow students to take the lead in their innovative learning and allow faculty to facilitate project-based evidence-based pedagogy., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2023 National League for Nursing.)