• Time Spent by Ophthalmologists on EHRs

    Written By: Lynda Seminara
    Selected By: Neil M. Bressler, MD, and Deputy Editors

    Journal Highlights

    JAMA Ophthalmology, November 2017

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    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.