{"id":"https://openalex.org/W4399884753","doi":"https://doi.org/10.1093/jamia/ocae156","title":"Consistency is key: documentation distribution and efficiency in primary care","display_name":"Consistency is key: documentation distribution and efficiency in primary care","publication_year":2024,"publication_date":"2024-06-21","ids":{"openalex":"https://openalex.org/W4399884753","doi":"https://doi.org/10.1093/jamia/ocae156","pmid":"https://pubmed.ncbi.nlm.nih.gov/38905016"},"language":"en","primary_location":{"id":"doi:10.1093/jamia/ocae156","is_oa":false,"landing_page_url":"http://dx.doi.org/10.1093/jamia/ocae156","pdf_url":null,"source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11258406/pdf/ocae156.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5077213401","display_name":"Nate C. Apathy","orcid":"https://orcid.org/0000-0002-7775-8544"},"institutions":[{"id":"https://openalex.org/I66946132","display_name":"University of Maryland, College Park","ror":"https://ror.org/047s2c258","country_code":"US","type":"education","lineage":["https://openalex.org/I66946132"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Nate C Apathy","raw_affiliation_strings":["Health Policy and Management, University of Maryland School of Public Health , College Park, MD 20742, United States"],"raw_orcid":"https://orcid.org/0000-0002-7775-8544","affiliations":[{"raw_affiliation_string":"Health Policy and Management, University of Maryland School of Public Health , College Park, MD 20742, United States","institution_ids":["https://openalex.org/I66946132"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5104332736","display_name":"Joshua Biro","orcid":null},"institutions":[{"id":"https://openalex.org/I86755215","display_name":"MedStar Health","ror":"https://ror.org/05atemp08","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I86755215"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Joshua Biro","raw_affiliation_strings":["National Center for Human Factors in Healthcare, MedStar Health Research Institute , Hyattsville, MD 20782, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"National Center for Human Factors in Healthcare, MedStar Health Research Institute , Hyattsville, MD 20782, United States","institution_ids":["https://openalex.org/I86755215"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5027068804","display_name":"A Jay Holmgren","orcid":"https://orcid.org/0000-0002-7939-6831"},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"A Jay Holmgren","raw_affiliation_strings":["Division of Clinical Informatics and Digital Transformation, University of California\u2014San Francisco School of Medicine , San Francisco, CA 94117, United States"],"raw_orcid":"https://orcid.org/0000-0002-7939-6831","affiliations":[{"raw_affiliation_string":"Division of Clinical Informatics and Digital Transformation, University of California\u2014San Francisco School of Medicine , San Francisco, CA 94117, United States","institution_ids":["https://openalex.org/I180670191"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5077213401"],"corresponding_institution_ids":["https://openalex.org/I66946132"],"apc_list":{"value":3967,"currency":"USD","value_usd":3967},"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.10667968,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"31","issue":"8","first_page":"1657","last_page":"1664"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.8852999806404114,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.8852999806404114,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12790","display_name":"Nursing Diagnosis and Documentation","score":0.030799999833106995,"subfield":{"id":"https://openalex.org/subfields/2910","display_name":"Issues, ethics and legal aspects"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12918","display_name":"Healthcare Systems and Technology","score":0.014399999752640724,"subfield":{"id":"https://openalex.org/subfields/1407","display_name":"Organizational Behavior and Human Resource Management"},"field":{"id":"https://openalex.org/fields/14","display_name":"Business, Management and Accounting"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/documentation","display_name":"Documentation","score":0.808720588684082},{"id":"https://openalex.org/keywords/consistency","display_name":"Consistency (knowledge bases)","score":0.743750810623169},{"id":"https://openalex.org/keywords/key","display_name":"Key (lock)","score":0.6797295212745667},{"id":"https://openalex.org/keywords/primary-care","display_name":"Primary care","score":0.6090090274810791},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.46777787804603577},{"id":"https://openalex.org/keywords/data-science","display_name":"Data science","score":0.3435071110725403},{"id":"https://openalex.org/keywords/medicine","display_name":"Medicine","score":0.29431718587875366},{"id":"https://openalex.org/keywords/artificial-intelligence","display_name":"Artificial intelligence","score":0.17251506447792053},{"id":"https://openalex.org/keywords/family-medicine","display_name":"Family medicine","score":0.12892407178878784},{"id":"https://openalex.org/keywords/computer-security","display_name":"Computer security","score":0.0925697386264801},{"id":"https://openalex.org/keywords/programming-language","display_name":"Programming language","score":0.05117964744567871}],"concepts":[{"id":"https://openalex.org/C56666940","wikidata":"https://www.wikidata.org/wiki/Q788790","display_name":"Documentation","level":2,"score":0.808720588684082},{"id":"https://openalex.org/C2776436953","wikidata":"https://www.wikidata.org/wiki/Q5163215","display_name":"Consistency (knowledge bases)","level":2,"score":0.743750810623169},{"id":"https://openalex.org/C26517878","wikidata":"https://www.wikidata.org/wiki/Q228039","display_name":"Key (lock)","level":2,"score":0.6797295212745667},{"id":"https://openalex.org/C2984752397","wikidata":"https://www.wikidata.org/wiki/Q3259956","display_name":"Primary care","level":2,"score":0.6090090274810791},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.46777787804603577},{"id":"https://openalex.org/C2522767166","wikidata":"https://www.wikidata.org/wiki/Q2374463","display_name":"Data science","level":1,"score":0.3435071110725403},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.29431718587875366},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.17251506447792053},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.12892407178878784},{"id":"https://openalex.org/C38652104","wikidata":"https://www.wikidata.org/wiki/Q3510521","display_name":"Computer security","level":1,"score":0.0925697386264801},{"id":"https://openalex.org/C199360897","wikidata":"https://www.wikidata.org/wiki/Q9143","display_name":"Programming language","level":1,"score":0.05117964744567871}],"mesh":[{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011320","descriptor_name":"Primary Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011320","descriptor_name":"Primary Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011320","descriptor_name":"Primary Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011320","descriptor_name":"Primary Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011320","descriptor_name":"Primary Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011320","descriptor_name":"Primary Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011320","descriptor_name":"Primary Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D017598","descriptor_name":"Efficiency, Organizational","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017598","descriptor_name":"Efficiency, Organizational","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017598","descriptor_name":"Efficiency, Organizational","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017598","descriptor_name":"Efficiency, Organizational","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017598","descriptor_name":"Efficiency, Organizational","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017598","descriptor_name":"Efficiency, Organizational","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017598","descriptor_name":"Efficiency, Organizational","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1093/jamia/ocae156","is_oa":false,"landing_page_url":"http://dx.doi.org/10.1093/jamia/ocae156","pdf_url":null,"source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},{"id":"pmid:38905016","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/38905016","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association : JAMIA","raw_type":null},{"id":"pmh:oai:pubmedcentral.nih.gov:11258406","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11258406","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11258406/pdf/ocae156.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"J Am Med Inform Assoc","raw_type":"Text"}],"best_oa_location":{"id":"pmh:oai:pubmedcentral.nih.gov:11258406","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11258406","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11258406/pdf/ocae156.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"J Am Med Inform Assoc","raw_type":"Text"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/4","score":0.8199999928474426,"display_name":"Quality Education"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4399884753.pdf"},"referenced_works_count":24,"referenced_works":["https://openalex.org/W2119731464","https://openalex.org/W2754518417","https://openalex.org/W2802884616","https://openalex.org/W2950509749","https://openalex.org/W2999645127","https://openalex.org/W3106065762","https://openalex.org/W3121779332","https://openalex.org/W3193105350","https://openalex.org/W4212932160","https://openalex.org/W4214528748","https://openalex.org/W4214604901","https://openalex.org/W4225264606","https://openalex.org/W4229017167","https://openalex.org/W4250639036","https://openalex.org/W4255411484","https://openalex.org/W4308061047","https://openalex.org/W4308371481","https://openalex.org/W4309885534","https://openalex.org/W4376226151","https://openalex.org/W4384120796","https://openalex.org/W4390061330","https://openalex.org/W4391659889","https://openalex.org/W4392296765","https://openalex.org/W4394759276"],"related_works":["https://openalex.org/W2618286804","https://openalex.org/W2329643025","https://openalex.org/W2002770077","https://openalex.org/W3131163342","https://openalex.org/W2092256833","https://openalex.org/W2142369114","https://openalex.org/W2361728394","https://openalex.org/W2166271660","https://openalex.org/W3089582840","https://openalex.org/W2352631095"],"abstract_inverted_index":{"OBJECTIVES:":[0],"We":[1,35,70,96,118,199],"analyzed":[2,84,107],"the":[3,45,85,125,253],"degree":[4],"to":[5,74,114,168,231,244,252,257],"which":[6],"daily":[7,77,122,206],"documentation":[8,53,81,92,104,115,123,142,176,207,224,246,260],"patterns":[9,26,78,89,129,191,237,261],"in":[10,138,203],"primary":[11,99],"care":[12,100],"varied":[13],"and":[14,21,58,83,90,106,110,135,216,233],"whether":[15],"specific":[16,250],"patterns,":[17,208],"consistency":[18,109,217],"over":[19],"time,":[20],"deviations":[22,111,234],"from":[23,44,188,235],"clinicians'":[24],"usual":[25,190],"were":[27,112,160,192,227,238],"associated":[28,193],"with":[29,157,163,179,194],"note-writing":[30],"efficiency.":[31,116],"MATERIALS":[32],"AND":[33],"METHODS:":[34],"used":[36,71],"electronic":[37],"health":[38],"record":[39],"(EHR)":[40],"active":[41,52,80,91],"use":[42],"data":[43],"Oracle":[46],"Cerner":[47],"Advance":[48],"platform":[49],"capturing":[50],"hourly":[51],"time":[54,82,93,143],"for":[55,65,131,182,255],"498":[56],"physicians":[57],"advance":[59],"practice":[60],"clinicians":[61],"(eg,":[62],"nurse":[63],"practitioners)":[64],"65":[66],"152":[67],"clinic":[68],"days.":[69],"k-means":[72],"clustering":[73],"identify":[75],"distinct":[76,121],"of":[79,133,141,165],"relationship":[86],"between":[87],"these":[88],"per":[94,146,150,154],"note.":[95],"determined":[97],"each":[98],"clinician's":[101],"(PCC)":[102],"modal":[103],"pattern":[105,171],"how":[108],"related":[113],"RESULTS:":[117],"identified":[119],"8":[120],"patterns;":[124],"3":[126],"most":[127],"common":[128],"accounted":[130],"80.6%":[132],"PCC-days":[134],"differed":[136],"primarily":[137],"average":[139],"volume":[140],"(78.1":[144],"minutes":[145,149,153],"day;":[147,151],"35.4":[148],"144.6":[152],"day);":[155],"associations":[156],"note":[158],"efficiency":[159,204,229],"mixed.":[161],"PCCs":[162,178,256],">80%":[164],"days":[166,185],"attributable":[167],"a":[169],"single":[170],"demonstrated":[172],"significantly":[173],"more":[174,220],"efficient":[175,196],"than":[177,222],"lower":[180],"consistency;":[181],"high-consistency":[183],"PCCs,":[184],"that":[186,210],"deviated":[187],"their":[189],"less":[195],"documentation.":[197],"DISCUSSION:":[198],"found":[200],"substantial":[201,228],"variation":[202],"across":[205],"suggesting":[209],"PCC-level":[211],"factors":[212],"like":[213],"EHR":[214],"facility":[215],"may":[218],"be":[219],"important":[221],"when":[223],"occurs.":[225],"There":[226],"returns":[230],"consistency,":[232],"consistent":[236,259],"costly.":[239],"CONCLUSION:":[240],"Organizational":[241],"leaders":[242],"aiming":[243],"reduce":[245],"burden":[247],"should":[248],"pay":[249],"attention":[251],"ability":[254],"execute":[258],"day-to-day.":[262]},"counts_by_year":[],"updated_date":"2026-05-28T09:10:13.091523","created_date":"2025-10-10T00:00:00"}
