# Assessing the Effects of EHR Optimization Interventions in Primary Care

> **NIH AHRQ R01** · BRIGHAM AND WOMEN'S HOSPITAL · 2024 · $400,000

## Abstract

ABSTRACT
Fifteen years after passage of the HITECH Act resulted in investment of billions of dollars into electronic health
record (EHR) adoption, physicians and health system leaders face competing pressures related to the EHR.
On one hand, widespread adoption of EHRs has had positive effects for patient safety and quality of care. On
the other hand, use of EHRs has significantly worsened the physician work experience, particularly for primary
care physicians (PCPs). In the context of ongoing threats to both the US primary care workforce and primary
care quality and sustainability, health system leaders struggle to identify interventions that contribute to
improved primary care quality while also enhancing PCPs’ EHR interactions and wellbeing.
To address this gap, and in response to SEN-HS-22-011, we will evaluate the impact of three common or
promising EHR-optimization interventions that are often considered and offered by health system leaders and
adopted by primary care clinics and PCPs, either individually or in combination: 1) scribes, 2) advanced team-
based inbox messaging support, and 3) artificial intelligence (AI)-assisted inbox messaging support. At present,
health system leaders lack robust, actionable evidence on the benefits and drawbacks of these interventions,
including their impact on patients’ quality of care and their relative cost effectiveness. Leveraging data and
insights from three community-based and three academic primary care practice networks representing 800
PCPs caring for 1 million patients at 210 practice sites, we will: 1) test for associations between use of the 3
EHR-optimization interventions, individually or in combination, with PCPs’ EHR time and wellbeing, and
patient-panel level quality of care and utilization of care; 2) describe PCP and team member experiences of
adopting the 3 EHR-optimization interventions and the mechanisms by which the interventions are associated
with EHR time, physician wellbeing, and quality and utilization of care; and 3) quantify the costs to health
systems of implementing each of the 3 EHR-optimization interventions, either individually or in combination.
This study blends quantitative, qualitative, and cost effectiveness methods to generate information about how
to enhance PCPs’ EHR work while maintaining or enhancing quality of care. It brings together a strong,
interdisciplinary team of experts in primary care operations, quality of care, informatics, EHR activity log
research, and the clinician experience to generate rigorous evidence for healthcare leaders and policymakers
regarding the impact of EHR-optimization interventions across PCP and patient outcomes. It will additionally
generate evidence about the cost effectiveness of these interventions. The results of this study will guide
health systems leaders towards interventions that both address EHR-based challenges negatively impacting
the PCP work experience and maximize benefits of EHRs for physicians, patients, and he...

## Key facts

- **NIH application ID:** 10978784
- **Project number:** 1R01HS029470-01A1
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** DAVID W., MD,Msc BATES
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $400,000
- **Award type:** 1
- **Project period:** 2024-08-01 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10978784

## Citation

> US National Institutes of Health, RePORTER application 10978784, Assessing the Effects of EHR Optimization Interventions in Primary Care (1R01HS029470-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10978784. Licensed CC0.

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