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. 2016 Feb;8(1):39-44.
doi: 10.4300/JGME-D-15-00240.1.

Racing Against the Clock: Internal Medicine Residents' Time Spent On Electronic Health Records

Lu Chen, Uta Guo, Lijo C Illipparambil, Matt D Netherton, Bhairavi Sheshadri, Eric Karu, Stephen J Peterson, Parag H Mehta

Racing Against the Clock: Internal Medicine Residents' Time Spent On Electronic Health Records

Lu Chen et al. J Grad Med Educ. 2016 Feb.

Abstract

Background: Since the late 1980s, resident physicians have spent increasing amounts of time on electronic health record (EHR) data entry and retrieval. Objective longitudinal data measuring time spent on the EHR are lacking.

Objective: We sought to quantify the time actually spent using the EHR by all first-year internal medicine residents in a single program (N = 41).

Methods: Active EHR usage data were collected from the audit logs for May, July, and October 2014 and January 2015. Per recommendations from our EHR vendor (Cerner Corporation), active EHR usage time was defined as more than 15 keystrokes, or 3 mouse clicks, or 1700 "mouse miles" per minute. Active EHR usage time was tallied for each patient chart viewed each day and termed an electronic patient record encounter (EPRE).

Results: In 4 months, 41 interns accumulated 18,322 hours of active EHR usage in more than 33,733 EPREs. Each intern spent on average 112 hours per month on 206 EPREs. Interns spent more time in July compared to January (41 minutes versus 30 minutes per EPRE, P < .001). Time spent on the EHR in January echoed that of the previous May (30 minutes versus 29 minutes, P = .40).

Conclusions: First-year residents spent a significant amount of time actively using the EHR, achieving maximal proficiency on or before January of the academic year. Decreased time spent on the EHR may reflect greater familiarity with the EHR, growing EHR efficiencies, or other factors.

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Conflict of interest statement

Conflict of interest: The authors declare they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Time per Electronic Patient Record Encounter (EPRE) for Interns in July and October 2014 and January 2015 Note: The box and whisker plot represent differences in minutes spent per EPRE by different interns over the span of the study. The outliers are represented by an x.
FIGURE 2
FIGURE 2
Time Spent on the Electronic Health Record by Interns in May, July, and October 2014 and January 2015 Note: Time was rounded to the nearest minute. It should be noted that data from May represent the previous class of interns for comparison purposes.
FIGURE 3
FIGURE 3
Comparison of Time Spent on the Electronic Health Record by Resident Physicians in January 2015 Abbreviations: AP, average provider; PGY, postgraduate year; FP, fast provider; EPRE, electronic patient record encounter. Note: Time was rounded to the nearest minute.
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