Time Requirements for Electronic Health Record Use in an Academic Ophthalmology Center.

Area of Science:

• Ophthalmology
• Health Informatics
• Medical Practice Management

Background:

• Electronic health record (EHR) systems are integral to modern medicine.
• Physician concerns exist regarding EHRs negatively impacting productivity.
• Evolving reimbursement models necessitate detailed quality and cost documentation.

Purpose of the Study:

• To quantitatively analyze the time ophthalmologists spend using EHR systems.
• To assess the impact of EHR use on ophthalmologist productivity and patient interaction.

Main Methods:

• A single-center cohort study involving 27 ophthalmologists over 3.5 years.
• Analysis of time stamps from medical records and EHR audit logs.
• Manual time-motion observation to categorize activities: EHR use, conversation, and examination.

Main Results:

• Ophthalmologists spent an average of 3.0 minutes (27%) of examination time on EHR use per patient.
• Total EHR use averaged 10.8 minutes per encounter, with 3.7 hours spent daily.
• Increased clinic volume correlated with decreased EHR time per encounter for high-billing physicians.

Conclusions:

• Ophthalmologist time with patients is limited, with EHR use consuming a significant portion.
• Substantial variability exists in how ophthalmologists utilize EHR systems.
• EHR time requirements present challenges to physician productivity and patient-centered care.