Internal Medicine Resident Engagement with a Laboratory Utilization Dashboard: Mixed Methods Study

The objective of this study was to measure internal medicine resident engagement with an electronic medical record‐based dashboard providing feedback on their use of routine laboratory tests relative to service averages. From January 2016 to June 2016, residents were e‐mailed a snapshot of their personalized dashboard, a link to the online dashboard, and text summarizing the resident and service utilization averages. We measured resident engagement using e‐mail read‐receipts and web‐based tracking. We also conducted 3 hour‐long focus groups with residents. Using grounded theory approach, the transcripts were analyzed for common themes focusing on barriers and facilitators of dashboard use. Among 80 residents, 74% opened the e‐mail containing a link to the dashboard and 21% accessed the dashboard itself. We did not observe a statistically significant difference in routine laboratory ordering by dashboard use, although residents who opened the link to the dashboard ordered 0.26 fewer labs per doctor‐patient‐day than those who did not (95% confidence interval, –0.77 to 0.25; P = 0.31). While they raised several concerns, focus group participants had positive attitudes toward receiving individualized feedback delivered in real time.