July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Changes in Electronic Health Record use time over a decade of use
Author Affiliations & Notes
  • Isaac Goldstein
    Oregon Health and Science University, Davis, California, United States
  • Michelle Hribar
    Oregon Health and Science University, Davis, California, United States
  • Michael F Chiang
    Oregon Health and Science University, Davis, California, United States
  • Footnotes
    Commercial Relationships   Isaac Goldstein, None; Michelle Hribar, None; Michael Chiang, Clarity Medical Systems (S), Novartis (C)
  • Footnotes
    Support  NIH Grant P30 EY010572, and R00LM012238, Unrestricted departmental funding from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4156. doi:
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      Isaac Goldstein, Michelle Hribar, Michael F Chiang; Changes in Electronic Health Record use time over a decade of use. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4156.

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

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Abstract

Purpose : Over the past decade, as Electronic Health Records (EHRs) have been widely adopted across the United States, concerns have arisen about their impact on clinical efficiency, provider workload, and provider burnout. Whether EHR use time for ophthalmologists has changed during this time, as physicians and staff have become increasingly accustomed to their use, is unknown. This study quantifies total EHR time requirements for providers at a large tertiary care hospital in the year of EHR adoption, five years after adoption, and ten years after adoption.

Methods : We analyzed EHR audit logs and visit records from 65 providers from 11 subspecialties who saw patients in 2006, 2011, or 2016. Overall EHR use time, which included time spent on administrative and direct and indirect patient care activities, was calculated as the number of unique minutes found in a provider’s audit logs. EHR time per visit was calculated as total EHR time divided by the number of office visits for a given year, and EHR hours per clinic day was extrapolated from EHR time per visit and the mean patients seen on a given half-day. P-values were calculated using t tests.

Results : On average, providers used the EHR for 13.0 ± 7.4 minutes per visit and 2.6 ± 1.1 hours per clinic day in 2006, 15.2 ± 11.0 minutes per visit and 3.5 ± 1.9 (p<.009) hours per clinic day in 2011, and 16.2 ± 8.6 minutes per visit (p=.02) and 4.1 ± 1.4 (p<.009) hours per clinic day in 2016 (Table 1). In 2016, 9 of 11 subspecialties had longer average EHR minutes per visit compared to 2006, while all sub-specialties had longer average EHR use time per clinic day in 2016 compared to 2006 (Table 1). On average, providers saw more patients in a half-day clinic session in both 2011 and 2016 compared to 2006 (Table 2).

Conclusions : On average, providers spent significantly more time using the EHR, and saw significantly more patients in a half-day clinic, after a decade of using the EHR. Our study suggests time requirements for EHRs have not improved with time and that new utilization methods and EHR interfaces may be called for.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Shows mean minutes per visit and hours per clinic day overall and by specialty in 2006, 2011, and 2016, with p-values comparing difference in means to 2006 calculated by paired t tests.

Shows mean minutes per visit and hours per clinic day overall and by specialty in 2006, 2011, and 2016, with p-values comparing difference in means to 2006 calculated by paired t tests.

 

Shows mean patients per half-day clinic session overall and by specialty in 2006, 2011, and 2016, with p-values comparing difference in means to 2006 calculated by t tests.

Shows mean patients per half-day clinic session overall and by specialty in 2006, 2011, and 2016, with p-values comparing difference in means to 2006 calculated by t tests.

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