Primary care physician time utilization before and after implementation of an electronic health record: a time-motion study

  • Authors:

  • Lisa Pizziferri;Anne F. Kittler;Lynn A. Volk;Melissa M. Honour;Sameer Gupta;Samuel Wang;Tiffany Wang;Margaret Lippincott;Qi Li;David W. Bates

  • Affiliations:

  • Partners HealthCare System, Inc., Information Systems;Partners HealthCare System, Inc., Information Systems;Partners HealthCare System, Inc., Information Systems;Division of General Medicine, Department of Medicine, Brigham and Women's Hospital Boston, MA;Partners HealthCare System, Inc., Information Systems;Partners HealthCare System, Inc., Information Systems;Partners HealthCare System, Inc., Information Systems;Partners HealthCare System, Inc., Information Systems;Partners HealthCare System, Inc., Information Systems;Partners HealthCare System, Inc., Information Systems and Division of General Medicine, Department of Medicine, Brigham and Women's Hospital Boston, MA and Harvard School of Public Health and Harv ...

  • Venue:
  • Journal of Biomedical Informatics - Special issue: Human-centered computing in health information systems. Part 2: Evaluation
  • Year:
  • 2005

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Abstract

Despite benefits associated with the use of electronic health records (EHRs), one major barrier to adoption is the concern that EHRs may take longer for physicians to use than paper-based systems. To address this issue, we performed a time-motion study in five primary care clinics. Twenty physicians were observed and specific activities were timed during a clinic session before and after EHR implementation. Surveys evaluated physicians' perceptions regarding the EHR. Post-implementation, the adjusted mean over-all time spent per patient during clinic sessions decreased by 0.5 min (p = 0.86; 95% confidence interval [-5.05, 6.04]) from a preintervention adjusted average of 27.55 min (SE = 2.1) to a post-intervention adjusted average of 27.05 min (SE = 1.6). A majority of survey respondents believed EHR use results in quality improvement, yet only 29% reported that EHR documentation takes the same amount of time or less compared to the paper-based system. While the EHR did not require more time for physicians during a clinic session, further studies should assess the EHR's potential impact on non-clinic time.