Higher electronic health record burden among women physicians in academic ambulatory medicine

Electronic health record (EHR) work may differently affect women and men physicians. Identifying gender discrepancies in EHR work across different specialties may inform strategies to reduce EHR burdens.

We retrospectively evaluated EHR use by ambulatory physicians in 4 specialties (2 procedural [cardiology and gastroenterology] and 2 nonprocedural [internal medicine and rheumatology]) during 1 year at a large academic medical institution. Gender differences in EHR and clinical workload across specialties were evaluated by analysis of variance. Mixed-effects linear regression models analyzed gender differences in EHR workload controlling for specialty. Significant differences were additionally examined by stratifying procedural and nonprocedural specialties.

Clinical and EHR workload varied across specialties (P <.05), though scheduled clinical workload did not differ by gender. Controlling for specialty, women physicians spent more time per appointment on In Basket messages (P =.001), sent more Secure Chat messages per appointment (P =.003), and spent more time in the EHR outside 7:00 AM-7:00 PM (P <.001) than men. Gender differences in messaging were concentrated among the procedural physicians. Women procedural physicians spent more time on In Basket messages (P <.001) and sent more Secure Chat messages (P =.007) than men, whereas these differences did not occur among nonprocedural physicians.

Women physicians had greater EHR burdens despite similar scheduled clinical workloads as men. The greater messaging workload predominantly affected women procedural physicians.

Gender disparities in EHR burden in ambulatory specialties vary between procedural and nonprocedural fields. Future research is needed to mitigate gender inequity in EHR workloads.