Time Spent by Ophthalmologists on EHRs
JAMA Ophthalmology, November 2017
Although electronic health records (EHRs) have multiple advantages in clinical practice, many physicians see them as an obstacle to productivity. In a study of EHR use among ophthalmologists, Read-Brown et al. found that a substantial portion of time spent with patients is indeed devoted to EHRs.
This study entailed 2 types of research: time motion and data analytics. In the time-motion phase, manual observation was used to compare time spent on the EHR with that spent on patient conversation and examination. In the data analytics phase, EHR time stamps were used for large-scale determination of the time spent on EHRs both during and after patient visits. All 27 participating ophthalmologists (10 women, 17 men) had a standard clinical practice at the Casey Eye Institute of Oregon Health & Science University in Portland.
The mean total time spent during each patient encounter was 11.2 minutes (standard deviation [SD], 6.3 minutes). Of that, 3 minutes were devoted to EHR use (27% of the visit time), 4.7 minutes to conversation with the patient (42%), and 3.5 minutes to the examination (31%). The ophthalmologists’ mean total per-encounter EHR time was 10.8 minutes (SD, 5.0 minutes; range, 5.8-28.6 minutes). Overall, 3.7 hours of each full clinic day was spent on EHRs (2.1 hours during the encounter, 1.6 hours at other times). Linear mixed-effects models demonstrated a positive correlation between EHR use and billing level and a negative correlation between per-encounter EHR use and clinic volume.
The findings emphasize the importance of creating EHR systems that meet the needs of patients and physicians, the authors said. (Also see related commentary by Michael V. Boland, MD, PhD, in the same issue.)
The original article can be found here.