title: Racing Against the Clock: Internal Medicine Residents' Time Spent On Electronic Health Records.
abstract: BACKGROUND
  Since the late 1980s, resident physicians have spent increasing amounts of time on electronic health record (EHR) data entry and retrieval. Objective longitudinal data measuring time spent on the EHR are lacking.
  
  
  OBJECTIVE
  We sought to quantify the time actually spent using the EHR by all first-year internal medicine residents in a single program (N = 41).
  
  
  METHODS
  Active EHR usage data were collected from the audit logs for May, July, and October 2014 and January 2015. Per recommendations from our EHR vendor (Cerner Corporation), active EHR usage time was defined as more than 15 keystrokes, or 3 mouse clicks, or 1700 "mouse miles" per minute. Active EHR usage time was tallied for each patient chart viewed each day and termed an electronic patient record encounter (EPRE).
  
  
  RESULTS
  In 4 months, 41 interns accumulated 18,322 hours of active EHR usage in more than 33,733 EPREs. Each intern spent on average 112 hours per month on 206 EPREs. Interns spent more time in July compared to January (41 minutes versus 30 minutes per EPRE, P < .001). Time spent on the EHR in January echoed that of the previous May (30 minutes versus 29 minutes, P = .40).
  
  
  CONCLUSIONS
  First-year residents spent a significant amount of time actively using the EHR, achieving maximal proficiency on or before January of the academic year. Decreased time spent on the EHR may reflect greater familiarity with the EHR, growing EHR efficiencies, or other factors.
authors.forename: Lu
authors.initials: L
authors.lastname: Chen
authors.forename: Uta
authors.initials: U
authors.lastname: Guo
authors.forename: Lijo C
authors.initials: LC
authors.lastname: Illipparambil
authors.forename: Matt D
authors.initials: MD
authors.lastname: Netherton
authors.forename: Bhairavi
authors.initials: B
authors.lastname: Sheshadri
authors.forename: Eric
authors.initials: E
authors.lastname: Karu
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Peterson
authors.forename: Parag H
authors.initials: PH
authors.lastname: Mehta
mesh_terms: D057286:Electronic Health Records; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D010817:Physician-Patient Relations; D010820:Physicians; D013997:Time Factors