Abstract
Background The amount of time that health care clinicians (physicians and nurses) spend interacting
with the electronic health record is not well understood.
Objective This study aimed to evaluate the time that health care providers spend interacting
with electronic health records (EHR).
Methods Data are retrieved from Ovid MEDLINE(R) and Epub Ahead of Print, In-Process and Other
Non-Indexed Citations and Daily, (Ovid) Embase, CINAHL, and SCOPUS.
Study Eligibility Criteria Peer-reviewed studies that describe the use of EHR and include measurement of time
either in hours, minutes, or in the percentage of a clinician's workday. Papers were
written in English and published between 1990 and 2021.
Participants All physicians and nurses involved in inpatient and outpatient settings.
Study Appraisal and Synthesis Methods A narrative synthesis of the results, providing summaries of interaction time with
EHR. The studies were rated according to Quality Assessment Tool for Studies with
Diverse Designs.
Results Out of 5,133 de-duplicated references identified through database searching, 18 met
inclusion criteria. Most were time-motion studies (50%) that followed by logged-based
analysis (44%). Most were conducted in the United States (94%) and examined a clinician
workflow in the inpatient settings (83%). The average time was nearly 37% of time
of their workday by physicians in both inpatient and outpatient settings and 22% of
the workday by nurses in inpatient settings. The studies showed methodological heterogeneity.
Conclusion This systematic review evaluates the time that health care providers spend interacting
with EHR. Interaction time with EHR varies depending on clinicians' roles and clinical
settings, computer systems, and users' experience. The average time spent by physicians
on EHR exceeded one-third of their workday. The finding is a possible indicator that
the EHR has room for usability, functionality improvement, and workflow optimization.
Keywords
electronic health records and systems - inpatient (inpatient CPOE) - workflow - time
and motion - task performance and analysis
