Description
Background: Neurologists suffer from considerable physician burnout. This may be related to time spent reviewing clinical data for neurological decision-making. Consultation turnaround time (TAT) may reflect time spent in clinical data review, and informatics tools that aggregate multiple types of neurological data at the point of care may help reduce consultation TAT.
Methods: At Columbia University Medical Center, we studied usage statistics of a Web-based neurological dashboard. We counted distinct initial neurological consultations at this institution in the 5 months before and after dashboard go-live (December 2017) and measured consultation TAT for both periods.
Results: By end April 2018, we identified 269 unique users, 684 dashboard hits (mean hits/user 2.3, SD 4.6) and 510 unique patient chart accesses. Thirty-three users (12.2%) were neurologists, of whom 26 (78.8%) were neurology housestaff; neurologists generated 221 (32.3% of total) page hits. In the 5 months preceding go-live, 1,158 neurology consultations were completed with a median TAT of 1.9 hours (IQR 2.6). In the 5 months after go-live, 1,409 neurology consultations were completed with a median TAT of 1.6 hours (IQR 2.3) (p for difference in medians <0.001). No institutional changes that affected consultation TAT or volume occurred over the study period.
Conclusion: We found that our dashboard was associated with a significant, short-term decrease in TAT, but the finding was limited in that we did not track dashboard usage during consultations. These results should be considered hypothesis-generating and further study is necessary to investigate the effect of such dashboards on cognitive load.
Describe the new knowledge and additional skills the participant will gain after attending your presentation.: Describe the burnout affecting neurologists
Identify neurological consultation time as a potential target for wellness interventions
Understand the diverse types of data needed to make neurological decisions
Develop hypotheses to investigate the effect of data aggregation on burnout in neurological (and non-neurological) specialties
Authors:
Benjamin Kummer (Presenter)
Icahn School of Medicine at Mount Sinai
Joshua Willey, Columbia University College of Physicians & Surgeons
Michael Zelenetz, NewYork-Presbyterian Hospital
Yiping Hu, Columbia University
Soumitra Sengupta, Columbia University
Mitchell Elkind, Columbia University College of Physicians & Surgeons
George Hripcsak, Columbia University
Presentation Materials: