A time-motion study of primary care physicians’ work in the electronic health record era

Richard A. Young, Sandra K. Burge, Kaparaboyna A Kumar, Jocelyn M. Wilson, Daniela F. Ortiz

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVES: Electronic health records (EHRs) have had mixed effects on the workflow of ambulatory primary care. In this study, we update previous research on the time required to care for patients in primary care clinics with EHRs. METHODS: We directly observed family physician (FP) attendings, residents, and their ambulatory patients in 982 visits in clinics affiliated with 10 residencies of the Residency Research Network of Texas. The FPs were purposely chosen to reflect a diversity of patient care styles. We measured total visit time, previsit chart time, face-to-face time, non-face time, out-of-hours EHR work time, and total EHR work time. RESULTS: The mean (SD) visit length was 35.8 (16.6) minutes, not counting resident precepting time. The mean time components included 2.9 (3.8) minutes working in the EHR prior to entering the room, 16.5 (9.2) minutes of face-to-face time not working in the EHR, 2.0 (2.1) minutes working in the EHR in the room (which occurred in 73.4% of the visits), 7.5 (7.5) minutes of non-face time (mostly EHR time), and 6.9 (7.6) minutes of EHR work outside of normal clinic operational hours (which occurred in 64.6% of the visits). The total time and total EHR time varied only slightly between faculty physicians, third-year and second-year residents. Multivariable linear regression analysis revealed many factors associated with total visit time including patient, physician, and clinic infrastructure factors. CONCLUSIONS: Primary care physicians spent more time working in the EHR than they spent in face-to-face time with patients in clinic visits.

Original languageEnglish (US)
Pages (from-to)91-99
Number of pages9
JournalFamily Medicine
Volume50
Issue number2
DOIs
StatePublished - Feb 1 2018

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Time and Motion Studies
Electronic Health Records
Primary Care Physicians
Ambulatory Care
Internship and Residency
Primary Health Care
Patient Care
Physicians
Workflow
Family Physicians

ASJC Scopus subject areas

  • Family Practice

Cite this

A time-motion study of primary care physicians’ work in the electronic health record era. / Young, Richard A.; Burge, Sandra K.; Kumar, Kaparaboyna A; Wilson, Jocelyn M.; Ortiz, Daniela F.

In: Family Medicine, Vol. 50, No. 2, 01.02.2018, p. 91-99.

Research output: Contribution to journalArticle

Young, Richard A. ; Burge, Sandra K. ; Kumar, Kaparaboyna A ; Wilson, Jocelyn M. ; Ortiz, Daniela F. / A time-motion study of primary care physicians’ work in the electronic health record era. In: Family Medicine. 2018 ; Vol. 50, No. 2. pp. 91-99.
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