Use of electronic health records increases time, documentation pressure for ophthalmology providers
A decade after ophthalmologists adopted the use of electronic health records (EHRs), providers have been found to spend more time using EHR for an office visit, generate longer notes and close the chart faster, according to a study. Such changes may increase time and documentation pressure for providers.
This single-centre cohort study, which involved 685,361 office visits and 70 ophthalmology providers, examined how the amount of time spent using EHRs as well as related documentation behaviours changed a decade after EHR adoption.
The investigators calculated time spent using EHR associated with each individual office visit using EHR audit logs and determined chart closure times and progress note length from secondary EHR data. Linear mixed models were generated to track and model how these metrics changed from 2006–2016.
In 2006, median EHR time per office visit was 4.2 minutes (interquartile range [IQR], 3.5 minutes), and this increased to 6.4 minutes (IQR, 4.5 minutes) in 2016. Median chart closure time in 2006 was 2.8 hours (IQR, 21.3 hours), which decreased to 2.3 hours (IQR, 18.5 hours) in 2016. Median note length was 1,530 characters (IQR, 1,435 characters) in 2006 and increased to 3,838 characters (IQR, 2,668.3 characters) in 2016.
In linear mixed models, EHR time per office visit was 31.9±0.2-percent greater from 2014–2016 vs 2006–2010 (p<0.001), chart closure time was 6.7±0.3-hours shorter from 2014–2016 vs 2006–2010 (p<0.001), and note length was 1,807.4±6.5-characters longer from 2014–2016 vs 2006–2010 (p<0.001).
“EHR redesign and new documentation regulations may help to address these issues,” the investigators said.