COVID Impact on Physician EHR Workload: A Hidden Epidemic?

To examine whether electronic health record (EHR) workload for primary care and other physicians was associated with increases in COVID-19 cases by region of the United States (US).

Retrospective data analysis of Epic EHR workload measures for almost 500,000 outpatient physicians and other physicians across the US from May 2019 to May 2022.

The association of COVID-19 disease rates on time in the EHR varied by specialty. For primary care physicians, increases in regional disease prevalence were associated with significant increases in the time spent in the In Basket as well as "pajama time" (time outside of scheduled work hours); for other specialties, increases in COVID rates were associated with smaller increases in In Basket time and some region-specific decreases in pajama time. For all participants, regardless of specialty, overall EHR workload increased over the course of the pandemic.

Increases in COVID-19 cases were associated with increased EHR workload for outpatient physicians across the US, with the greatest impact on primary care physicians performing asynchronous patient care tasks. These findings capture the experience of almost half a million physicians and illuminate how mitigating burnout from a global pandemic likely also extends to efforts to reduce EHR workload.

Our results show direct impacts of COVID-19 rates on physician workloads, particularly in primary care, and can hopefully inform future efforts to manage workload should another pandemic occur.