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. 2020 Jul 1;15(7):e0233004.
doi: 10.1371/journal.pone.0233004. eCollection 2020.

Analyses of electronic health records utilization in a large community hospital

Gautam Verma  1 , Alexander Ivanov  1 , Francis Benn  1 , Anil Rathi  1 , Nathaniel Tran  1 , Ashwad Afzal  1 , Parag Mehta  1 , John F Heitner  1
Affiliations

Analyses of electronic health records utilization in a large community hospital

Gautam Verma et al. PLoS One. .

Abstract

Introduction: The Electronic Health Record (EHR) has become an integral component of healthcare delivery. Survey based studies have estimated that physicians spend 4-6 hours of their workday devoted to EHR. Our study was designed to use computer software to objectively obtain time spent on EHR.

Methods: We recorded EHR time for 248 physiciansover 2 time intervals. EHR active use was defined as more than 15 keystrokes, or 3 mouse clicks, or 1700 "mouse miles" per minute. We recorded total time and % of work hours spent on EHR, and differences in those based on seniority. Physicians reported duty hours using a standardized toolkit.

Results: Physicians spent 3.8 (±2) hours on EHR daily, which accounted for 37% (±17%), 41% (±14%), and 45% (±12%) of their day for all clinicians, residents, and interns, respectively. With the progression of training, there was a reduction in EHR time (all p values <0.01). During the first academic quarter, clinicians spent 38% (± 8%) of time on chart review, 17% (± 7%) on orders, 28% (±11%) on documentation (i.e. writing notes) and 17% (±7%) on other activities (i.e. physician hand-off and medication reconciliation). This pattern remained unchanged during the fourth quarter.

Conclusions: Physicians spend close to 40% of their work day on EHR, with interns spending the most time. There is a significant reduction in time spent on EHR with training and greater experience, although the overall amount of time spent on EHR remained high.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Percentage of time on EMR for all clinicians.
Fig 2
Fig 2. Time spent on EMR daily (%) and clinician training.
Blue—First academic quarter; Orange—Fourth academic quarter.
Fig 3
Fig 3. Time spent on EMR daily (%) and resident seniority.
Blue—First academic quarter; Orange—Fourth academic quarter.
Fig 4
Fig 4
(a) Allocation of time on EMR for all Clinicians. (b) Allocation of time on EMR for all Residents.
Fig 5
Fig 5
(a) Total number of patient encounters in 2 week period by different specialty. (b) Time spent per patient by different specialties.
See this image and copyright information in PMC

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