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Immediate Chart-Closure Rates
Dec 2020

Immediate Chart-Closure Rates

Authored by:  Lauren Manzione, 12/18/2020 | Read Time: 4 minutes

The percentage of charts closed immediately after patient interactions is a simple measure of a complex idea: a provider’s ability to keep up with their workload, which is influenced by time, efficiency, and many other factors. Comparing immediate chart-closure rates to other indicators suggests that providers who report higher chart-closure rates also have higher Net EHR Experience Scores and lower levels of burnout. Furthermore, closure rates also correlate with factors such as a provider’s perception of the quality of their initial EHR education and the degree to which a provider has personalized the EHR.

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What Correlation Exists between Chart-Closure Rates and the Following Factors?

net ehr experience score iconNet EHR Experience Score

Providers who report high chart-closure efficiency have higher Net EHR Experience Scores than those who report medium or low efficiency, with providers in ambulatory care settings reporting slightly higher satisfaction across all three efficiency groups. For the purposes of this report, high charting efficiency is defined as closing more than 66% of charts immediately after patient encounters or rounds; medium efficiency is defined as immediately closing 34%–66% of charts; and low efficiency is defined as immediately closing 33% or less.

net ehr experience score

Note: The Net EHR Experience Score (NEES) is a snapshot of providers’ overall satisfaction with the EHR. The survey asks respondents to rate factors such as the EHR’s efficiency, functionality, impact on care, and so on. The NEES is then calculated by subtracting the percent of negative user feedback from the percent of positive user feedback. Scores can range from -100% (all negative feedback) to +100% (all positive feedback).

provider burnout iconProvider Burnout

Higher levels of self-reported provider burnout are correlated with lower immediate chart-closure rates, particularly among ambulatory providers. Inpatient providers who say that symptoms of burnout won’t go away or that they are completely burned out have higher closure rates than their ambulatory counterparts. Another perspective of this correlation (see Figure 11 in the Expanded Insights section) shows that providers who spend more time documenting after-hours also experience a greater likelihood of burning out. These two factors together suggest a relationship between charting efficiency and burnout. This correlation makes sense as those with the lowest chart-closure rates spend the most time charting after hours and say that this work contributes to their burnout. The correlation is particularly apparent among ambulatory providers. While charting burden may be a contributor to burnout, it is also possible that burned-out providers are less efficient in their charting.
immediate chart closure rates by burnout and care location

initial ehr training iconInitial EHR Training

There is a positive correlation between providers’ agreement that their initial EHR training prepared them well and their chart-closure rates. Providers who strongly agree with this statement have the highest closure rates, while those who strongly disagree with this statement have the lowest. This correlation exists for both ambulatory and inpatient providers and suggests that quality training could increase providers’ charting efficiency.

immediate chart closure rates by care location and agreement that initial ehr training was high quality

ehr personalization iconEHR Personalization

immediate chart closure rates by documentation method and care locationProviders who use personalization tools for documentation have higher immediate chart-closure rates than those who use other documentation methods, such as voice recognition, personal entry, scribes, or dictation. Specifically, effective use of order sets and lists appears to have the greatest influence on immediate chart-closure rates, while filters appear to have a limited impact. The impact of other personalization tools varies.

difference in immediate chart closure rates
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2019 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.