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Quantifying and Visualizing Emergency Physician Workflow: Observational Time-Motion Study
Andrew J Henreid1,2, Kimon L H Ioannides3,4, Joshua M Pevnick1
1Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, United States, 1 310-423-3141.
JMIR Medical Informatics
|July 24, 2026
Summary
Emergency physicians spend over a third of their shift on computers, exceeding patient care time. They also work 1-2 hours post-shift, highlighting workflow inefficiencies and the need for optimization.
Area of Science:
- Emergency Medicine
- Health Informatics
- Workflow Analysis
Background:
- Emergency physicians experience significant workflow challenges in the emergency department (ED) due to unpredictable environments, interruptions, and documentation demands.
- Increased computer-based work detracts from direct patient care, potentially impacting care quality, communication, and patient safety.
Purpose of the Study:
- To quantify and visualize the time allocation of emergency physicians during ED shifts.
- To specifically analyze the proportion of time spent on computer-based tasks.
Main Methods:
- A cross-sectional observational time-motion study was conducted in a high-volume urban ED.
- The TimeCaT application was used for continuous tracking of physician activities, including computer use, patient care, and communication.
- Electronic health record logs were analyzed to estimate post-shift computer use.
Main Results:
- Physicians spent a median of 34.1% of their shift on computers and 26.9% with patients.
- An additional median of 1.3 hours was spent on computers after scheduled shifts.
- Workflow visualizations revealed frequent task switching and significant variability in shift fragmentation.
Conclusions:
- Emergency physicians dedicate more than one-third of their shift to computer work, surpassing time spent with patients.
- Significant post-shift computer use necessitates strategies to improve workflow efficiency.
- Reducing non-essential computer time is crucial for enhancing patient care and safety in the ED.
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