How the pandemic changed clinician EHR use: 9 study insights 

The COVID-19 pandemic prompted an initial decrease and then spike in the amount of time clinicians spend in their EHR, both during and after the workday, according to a study published Dec. 9 in the Journal of the American Medical Informatics Association

For the study, researchers from University of California San Francisco, Palo Alto, Calif.-based Stanford University and Cambridge, Mass.-based Harvard University measured data on ambulatory care clinicians' EHR use in 366 health systems across the U.S. Data was pulled from December 2019-20, and all participating health systems used an Epic EHR system. 

Researchers used descriptive statistics for clinician EHR use, including active-use time across clinical activities, time spent after hours and in-basket messages received. 

Nine study insights: 

1. Clinician time spent in the EHR per day decreased at the onset of the pandemic but had recovered to levels higher than pre-COVID-19 by July 2020. 

2. The average EHR time per day ranged between 80.4 and 80.9 minutes per day between Dec. 29, 2019, and March 14, 2020. 

3. The average EHR after-hours time per day was between 19.2 and 20.6 minutes between Dec. 29, 2019, and March 14, 2020. 

4. Both EHR time per day and after-hours time per day dropped significantly at the start of the pandemic, from March 15, 2020, through July 4, 2020. During this period, average EHR time per day decreased 23 percent to 64.9 minutes the week of March 29. This figure recovered to 85.7 minutes on average during the week of June 28. 

5. After-hours EHR time dropped to a low of 12.1 minutes during the week of April 5, 2020, before increasing back to an average of 20.5 minutes during the week of June 28, 2020. 

6. Since July 5, 2020, the total EHR time per day has been slightly higher than the pre-COVID-19 period, at an average of 86.4 minutes. After-hours EHR time has seen a smaller increase to an average of 19.8 minutes. 

7. For in-basket messages, overall, messages received per day increased slightly compared to the pre-pandemic baseline, with clinicians receiving 4 percent more messages the week of July 5, 2020, compared with the 11-week pre-pandemic average. 

8. The increase in EHR time and after-hours time was driven by the time spent in clinical review and in-basket messaging, with clinicians getting 157 percent of their pre-pandemic baseline messages from patients starting in July 2020. 

9. Study authors concluded that policymakers and health system leaders looking to integrate telemedicine into their post-pandemic workflows should be aware of the new EHR time demands on clinicians to avoid burnout.


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