title: National estimates of the impact of electronic health records on the workload of primary care physicians.
abstract: Eighty-four thousand primary care physicians have received $1.3 billion in HITECH payments for EHR adoption. However, little is known about how this will impact primary care workload efficiency and the national primary care shortage. This study examines whether EHR is associated with increases in face time with the patient per visit and increases in the physician's patient volume per week.
  
  
  
  We used a nationally representative sample of 37,962 patient visits to 1470 primary care physicians during the pre-HITECH years 2006-2009 from the restricted-access version of the National Ambulatory Medical Care Survey. Quantile regressions were used to estimate the effects of EHR use on patient face time per visit and physician's patient volume per week at different points of the time and volume distributions.
  
  
  
  Primary care physicians with EHR spend an extra 1.3 face time minutes per visit, or 1.5 extra hours per week. This is 34,000 extra hours of face time per week in the U.S. However, physician age matters. Among young physicians, EHR use is associated with a decline in weekly patient volume, while EHR use among older physicians is associated with an increase in volume, regardless of initial practice size. If younger physicians behaved like older physicians when adopting EHR, there would be 37,600 additional patient visits per week in the U.S., the equivalent of adding 500 more primary care physicians to the U.S. workforce.
  
  
  
  EHR can enhance productivity/efficiency in primary care physician workloads.
authors.affiliation: School of Nursing and Health Studies, Northern Illinois University, Wirtz Hall 257, Dekalb, IL, 60115, USA. jaeyong.bae@niu.edu.
authors.forename: Jaeyong
authors.initials: J
authors.lastname: Bae
authors.affiliation: Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, 5600 Fishers Ln, Rockville, MD, 20857, USA.|McCourt School of Public Policy, Georgetown University, Washington, DC, USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Encinosa
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D017598:Efficiency, Organizational; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014481:United States; D016526:Workload / Q000706:statistics & numerical data*
keywords: Efficiency of care; Electronic health records; Physician workload; Primary care