January 13, 2020
2 min read

Physicians spend 16 minutes using EHR for each patient encounter

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Physicians spend, on average, 16 minutes and 14 seconds using an EHR for each patient encounter, with 11% of that time occurring after hours, according to a study published in the Annals of Internal Medicine.

“The time physicians have to spend on indirect patient care tasks creates time pressure on direct patient care — interview, physical exam, discussion — adds to the physician's cognitive load and can be difficult to integrate into the time we have face to face with the patient,” J. Marc Overhage, MD, PhD, a health care information technology executive at Cerner Corporation, told Healio Primary Care.

Overhage and David McCallie Jr, MD, former senior vice president of medical informatics at Cerner Corporation, conducted a descriptive study using data from the Cerner Lights On Network, which monitors EHR activity from physicians in 2,191 health care organizations in the United States. They calculated the average time that physicians of nonsurgical specialties spent using an EHR per encounter in ambulatory care settings, including time spent using EHRs after hours — between 6 p.m. and 6 a.m. on weekdays and any time during weekends. The primary outcome was the average time spent during a 1-month interval to account for work done in the days after the initial encounter.

Approximately 100 million patient encounters with 155,000 physicians were included in analyses.

Physicians spend, on average, 16 minutes and 14 seconds using an EHR for each patient encounter, with 11% of that time occurring after hours, according to a study published in the <em>Annals of Internal Medicine.
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The average time spent actively using an EHR each month was 16 minutes and 14 seconds per encounter across all specialties, with 11% of that time accounting for work completed after hours.

Chart review consumed 33% of this time (5 minutes, 22 seconds), followed by documentation at 24% (3 minutes, 51 seconds) and ordering at 17% (2 minutes, 42 seconds).

Among primary care physicians, the mean active time using an EHR per encounter was 19 minutes and 48 seconds. Physicians in internal medicine spent an average of 18 minutes and 19 seconds using the EHR per encounter, and those in family medicine used it for an average of 15 minutes and 52 seconds per encounter.

Overhage said the findings provide important information on the amount of time that physicians invest using EHRs, which is often overlooked by patients and policymakers.

“It is, of course, important to maximize the efficiency with which physicians can care for patients,” he said. “The health care system also needs to be thoughtful about the tasks we ask physicians to do and which tasks other members of the care team, including the patient, can perform as well or better in order to free physicians to focus on their unique contributions.”


In an editorial accompanying the study, Julia Adler-Milstein, PhD, associate professor of medicine at the University of California, San Francisco, noted that the study provides information on which aspects of EHRs need to be optimized. She explained that tools have been developed to improve documentation and ordering on EHRs, but more work can be done to optimize chart reviews.

“Although investments in visualization tools and predictive models or articial intelligence–enabled tools aim to help identify critical problems that could otherwise be missed, few target the outpatient setting and address common pain points like information synthesis,” she wrote. – by Erin Michael

Disclosures: Aldir-Milstein reports no relevant financial disclosures. Overhage reports personal fees from Cerner Corporation outside the submitted work. Please see study for all other authors’ relevant financial disclosures.