Literature Review

Physicians and EHR time


Clinical question: How much time do ambulatory-care physicians spend on electronic health records (EHRs)?

Background: There is growing concern about physicians’ increased time and effort allocated to the EHR and decreased clinical face time and meaningful interaction with patients. Prior studies have shown that increased physician EHR task load is associated with increased physician stress and dissatisfaction.

Study design: Time and motion observation study.

Setting: Ambulatory-care practices.

Synopsis: Fifty-seven physicians from 16 practices in four U.S. states participated and were observed for more than 430 office hours. Additionally, 21 physicians completed a self-reported after-hours diary. During office hours, physicians spent 49.2% of their total time on the EHR and desk work and only 27% on face time with patients. While in the exam room, physicians spent 52.9% of the time on direct clinical face time and 37% on the EHR and desk work. Self-reported diaries showed an additional 1-2 hours of follow-up work on the EHR. These observations might not be generalizable to other practices. No formal statistical comparisons by physicians, practice, or EHR characteristics were done.

Bottom line: Ambulatory-care physicians appear to spend more time with EHR tasks and desk work than clinical face time with patients.

Citation: Sinsky C, Colligan L, Li L, et al. Allocation of physician time in ambulatory practice: a time and motion studies in 4 specialties [published online ahead of print Sept. 6, 2016]. Ann Intern Med. 165(11):753-760.

Dr. Briones is an assistant professor at the University of Miami Miller School of Medicine and medical director of the hospitalist service at the University of Miami Hospital.

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