Internal medicine residents spend 5 hours per day on EHR data entry

Score one for the EHR detractors: A new study of 41 first-year internal medicine residents found that each spent an average of 112 hours per month on 206 electronic record encounters — about five hours per day for 10 patient records. The results appear in the Journal of Graduate Medical Education.

Researchers from New York Methodist Hospital and Weill Cornell Medical College in New York measured Cerner EHR usage data for the residents in May, July and October of 2014, and January 2015. They defined usage as a minimum of 15 key strokes, three mouse clock or 1700 "mouse miles" per minute — the distance a cursor travels across a monitor. Over the four months tallied by researchers, the interns spent a total of 18,322 hours to enter data during 33,733 electronic patient record encounters.

In July 2014, interns were spending an average of 40 minutes per record encounter and an average of 30 minutes by January 2015. The researchers attribute this improvement to greater familiarity with the systems and improvements in EHR efficiency, among other factors.

"Although increased familiarity reduced time spent on clinical documentation, a significant portion of an intern's day is still consumed by clinical computer work," the authors wrote. "Our data correlate well with national survey data, showing that residents spent more than four hours per day on clinical documentation. Furthermore, a nationwide survey revealed that residents' perceptions of the time devoted to documentation were generally negative; residents felt that clinical documentation took time away from education, patient care, and more importantly, motivation to provide high-quality care."

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