Preambient Artificial Intelligence Clinical Documentation Time for Pediatric Residents: A 3-Year Baseline...

Area of Science:

• Medical Informatics
• Pediatric Residency Education
• Healthcare Administration

Background:

• Electronic health records (EHRs) are integral to modern healthcare, but documentation demands pose challenges for resident physicians.
• Understanding the time commitment and variability in EHR documentation is crucial for optimizing resident workflows and well-being.

Purpose of the Study:

• To quantify the nature and extent of EHR documentation time among pediatric residents.
• To explore inter-individual variability in documentation time.
• To identify factors influencing documentation burden, such as resident year and time of day.

Main Methods:

• Retrospective, longitudinal study analyzing EHR audit log data from July 2021 to June 2024 at an academic children's hospital.
• Inclusion of all clinical notes contributed to by pediatric residents.
• Descriptive statistics and statistical comparisons (Welch's ANOVA, Games-Howell) of documentation time.

Main Results:

• 79 residents documented 156,898 clinical notes, averaging 2.1 hours of EHR work daily.
• Mean time per note was 12.1 minutes; first-year residents (PGY-1) contributed to over half of all notes.
• Over half of note editing occurred after hours (53.1%), with significant time spent on weekends and evenings.

Conclusions:

• Pediatric resident EHR documentation time is substantial, highest for PGY-1 residents, and frequently extends beyond typical work hours.
• Significant inter-individual variability in documentation time was observed.
• Findings provide a baseline for optimizing residency workflows and evaluating interventions to reduce documentation burden.