O3200: Utilization and Impact of a Physician-led Clinical Informatics Consult Service to Enhance Clinician Engagement and EHR Satisfaction

Background: Use of the electronic health record (EHR) is often cited as a source of stress, burnout, and workplace frustration among clinicians. Addressing inefficiencies and implementing EHR enhancements can lead to improved clinician satisfaction. Although our institution already had systems in place for clinicians to request EHR enhancements, they often experienced workflow challenges without a clear understanding of potential solutions to request. Without a specific EHR change request to propose, clinicians often failed to identify opportunities that would improve overall clinician experience with the EHR. To address this unmet need, we created a physician-led clinical informatics consult service to engage front-line clinicians and effectively improve their EHR experience. In this study, we sought to determine the utilization and impact of such a service.

Methods: Beginning in April 2021, we implemented a clinical informatics consult service at an large urban, free-standing, academic children’s hospital which consisted of a team of physician informaticists, clinical informatics fellows, nursing informaticists, and EHR educators. Others were included based on individual consult-specific needs (e.g., application analysts, legal and/or compliance officers, etc.). Awareness of the consult service was spread, through existing communication channels, regular EHR-related meetings, posted flyers in clinician workrooms, and by word of mouth. Consult requests were submitted by either an online intake form or internal email. Consults were classified by request into one of 6 categories and by outcome.

Results: In the first 24 months of operation, a total of 305 consults were submitted. The average number of consults per month increased by 40% year-over-year (2021 = 9.9/month, 2022 = 13.6/month, 2023 = 17.7/month). Consults came from 48 different specialties specialty or subspecialty groups, with the largest number being submitted by pediatric residents (n=55), gastroenterology (n=42), and hospitalist (n=21). Figure 1 shows classification of completed consults by request and outcome categories. Of the 289 were currently completed, 139 resulted in specific EHR requests. 81 consults identified educational gaps needing to be addressed. 19 would be addressed with future EHR enhancements already planned for at the time of consult, and 50 were deemed not feasible given current EHR functionality. Top requesting categories included enhancement (n=89), efficiency (n=83), communication (n=63), and patient safety concern (n=22).

Conclusion: After over two years of operation, institutional awareness of and provider demand for our clinical informatics consults service has been reflected in a substantial and persistent increase in consult volume over time, demonstrating its overall value and impact. This led to increased engagement of front-line clinicians which, in turn, can lead to improved EHR satisfaction and a reduction in EHR-related burnout.