# Evaluation of Impact of EHR Documentation Assistant Modalities on Provider and System Level Outcomes

> **NIH NIH R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2024 · $666,827

## Abstract

Project Summary
 Over the past decade, there has been a growing epidemic of physician burnout, driven most notably, by
Electronic Health Records (EHR), and the increasing amount of time providers spend on them. A number of
solutions have been developed to untether the provider from the EHR. Prior to the COVID-19 pandemic, the two
most widely adopted solutions were Speech Recognition (SR) and Medical Scribes (MS). The pandemic has
worsened many of these preexisting issues with EHR, and with the broad adoption of telemedicine, creating new
sociotechnical concerns. Fueled in part by this, 2 additional solutions, Virtual Scribes (VS) and Digital Scribes
(DS) have begun to be employed for both in-person and telemedicine visits. We have previously performed a
mixed methods evaluation of MS documenting significant barriers to successful adoption with significant variance
in practice and outcomes. In spite of this rapid expansion of options, there is little information available directly
to compare and contrast the ways they are co-opting provider work in the EHR, or their impact on provider activity
in the EHR, medical record completion/accuracy, and safety issues. At OHSU, providers who adopt MS have
baseline longer times to chart completion and significant greater amount of after-hours record completion, and
use of a MS or SR had no impact on these metrics, with many, higher performing providers, worsening with MS
adoption. These trends persisted and even widened with the use of telemedicine. The goal of this project is to
expand upon these initial findings and use a mixed methods approach to determine the impact of EHR
documentation assistance solutions on EHR use and provider workflow in ambulatory care. In Aim #1, we will
adapt the Rapid Assessment Protocol (RAP) for in-person and virtual evaluation to expand on our prior work
with MS to evaluate the impact of MS, VS, SR, and DS on provider workflow in the context of in-person and
telemedicine visits. We will then convene a multidisciplinary stakeholder group to review these findings to come
up with a series of metrics, both quantitative and simulation based, to allow for assessment of the 4 modalities.
In Aim #2, we will use EHR audit logs to determine the impact of adoption of each of these 4 modalities, including
data from OHSU and Medstar Health to improve generalizability, control for various EHR systems and allow for
anchoring back to the qualitative data in Aim #1. In Aim #3, we will use the data from the first 2 aims, to create
a high-fidelity simulation to all for direct head-to-head comparison of the 4 modalities on measures not reliably
extracted from EHR audit logs including note accuracy, time-on-task, EHR navigation and patient-provider
communication. In Aim #4, we will define and create a success matrix for selection of DA modalities to guide
decision making on the use of appropriate DA resources for a given specialty type and location. We will also
create a Documentation Assistance ...

## Key facts

- **NIH application ID:** 10796137
- **Project number:** 1R01LM014255-01A1
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Vishnu Mohan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $666,827
- **Award type:** 1
- **Project period:** 2024-09-17 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10796137

## Citation

> US National Institutes of Health, RePORTER application 10796137, Evaluation of Impact of EHR Documentation Assistant Modalities on Provider and System Level Outcomes (1R01LM014255-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10796137. Licensed CC0.

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