April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Time Motion Study of Electronic Health Record (EHR) Documentation Time in Ophthalmology Exams
Author Affiliations & Notes
  • Michelle Hribar
    Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR
  • Sarah Read-Brown
    Ophthalmology, Case Eye Institute, Oregon Health and Science University, Portland, OR
  • Maha Pasha
    Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR
    Ophthalmology, Case Eye Institute, Oregon Health and Science University, Portland, OR
  • Leah Reznick
    Ophthalmology, Case Eye Institute, Oregon Health and Science University, Portland, OR
  • Thomas Yackel
    Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR
  • Michael F Chiang
    Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR
    Ophthalmology, Case Eye Institute, Oregon Health and Science University, Portland, OR
  • Footnotes
    Commercial Relationships Michelle Hribar, None; Sarah Read-Brown, None; Maha Pasha, None; Leah Reznick, None; Thomas Yackel, None; Michael Chiang, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5589. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Michelle Hribar, Sarah Read-Brown, Maha Pasha, Leah Reznick, Thomas Yackel, Michael F Chiang; Time Motion Study of Electronic Health Record (EHR) Documentation Time in Ophthalmology Exams. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5589.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

Popular perception is EHR adoption in ophthalmology has resulted in increased time spent documenting during patient exams. Documentation time with EHR has been shown to be worse than with paper charts, with much of the documentation time occurring after the exam is completed [Chan et al, Am J Ophthalmol 2013], [Chiang et al, Trans Am Ophthalmol Soc 2013]. The purpose of this study is to measure the proportion of time spent using an EHR during a patient encounter using time-motion methods.

 
Methods
 

We performed a time-motion study of patient exams in the Casey Eye Institute at Oregon Health & Science University. Using paper forms and time stamping software (Emerald Timestamp; Emerald Sequoia, Los Gatos, CA), data was collected by 2 observers who shadowed the ophthalmologist. We recorded the duration of time the ophthalmologist spent documenting in the EHR, talking, and examining the patient. If the ophthalmologist was multitasking and talking while either examining or documenting, this was recorded exclusively as examination or documentation time. Times spent doing each of the three activities was tabulated during each patient exam. Patient encounters were categorized for analysis as either “routine” or “complex” in the opinion of the ophthalmologist. An exam was considered complex if the diagnosis was difficult or if the patient was challenging (e.g. a crying infant).

 
Results
 

Our observations represent 25 patient exams, on 4 days of clinic, from a single pediatric ophthalmologist. We found that the mean proportion of time spend documenting was 18% compared to 30% examining and talking 45% spend talking. This corresponded to mean ±SD times of 2.1 ± 1.1 minutes for documenting, 3.9 ± 2.7 minutes for examining, and 5.4 ± 2.3 minutes for talking (Table 1). Between routine vs. complex encounters, there were no statistically-significant differences in documentation or talking times between complex vs. routine exams (p = 0.1276, 0.2808 respectively), but there were nearly statistically-significant differences in times required for examining (p=0.0513).

 
Conclusions
 

EHR documentation time occupies a significant proportion of ophthalmology patient encounters. Future EHR designs that streamline data entry will help reduce the amount of time spent documenting during ophthalmologic exam, and allow more time for examination and communication.

  
Keywords: 460 clinical (human) or epidemiologic studies: health care delivery/economics/manpower • 465 clinical (human) or epidemiologic studies: systems/equipment/techniques  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×