title: Primary care physician time utilization before and after implementation of an electronic health record: a time-motion study.
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 overall time spent per patient during clinic sessions decreased by 0.5 min (p=0.86; 95% confidence interval [-5.05, 6.04]) from a pre-intervention 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.
authors.affiliation: Partners HealthCare System, Inc., Information Systems, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Pizziferri
authors.forename: Anne F
authors.initials: AF
authors.lastname: Kittler
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Volk
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Honour
authors.forename: Sameer
authors.initials: S
authors.lastname: Gupta
authors.forename: Samuel
authors.initials: S
authors.lastname: Wang
authors.forename: Tiffany
authors.initials: T
authors.lastname: Wang
authors.forename: Margaret
authors.initials: M
authors.lastname: Lippincott
authors.forename: Qi
authors.initials: Q
authors.lastname: Li
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D010821:Physicians, Family / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D017748:Time Management / Q000379:methods*; D013996:Time and Motion Studies; D014481:United States