Background The amount of time that providers spend using electronic health records (EHRs) to support the care delivery process is a concern for the U.S. health care system. Given the potential effect on patient care and the high costs related to this time, particularly for medical specialists whose work is largely cognitive, these findings warrant more precise documentation of the time physicians invest in these clinically focused EHR functions. Objective To describe how much time ambulatory medical subspecialists and primary care physicians across several U.S. care delivery systems spend on various EHR functions. Design Descriptive study. Setting U.S.-based, adult, nonsurgical, ambulatory practices using the Cerner Millennium EHR. Participants 155 000 U.S. physicians. Measurements Data were extracted from software log files in the Lights On Network (Cerner) during 2018 that totaled the time spent on each of the 13 clinically focused EHR functions. Averages per encounter by specialty were computed. Results This study included data from approximately 100 million patient encounters with about 155 000 physicians from 417 health systems. Physicians spent an average of 16 minutes and 14 seconds per encounter using EHRs, with chart review (33%), documentation (24%), and ordering (17%) functions accounting for most of the time. The distribution of time spent by providers using EHRs varies greatly within specialty. The proportion of time spent on various clinically focused functions was similar across specialties. Limitation Variation by health system could not be examined, and all providers used the same software. Conclusion The time spent using EHRs to support care delivery constitutes a large portion of the physicians' day, and wide variation suggests opportunities to optimize systems and processes. Primary Funding Source None.

中文翻译：

---

在门诊患者遇到电子病历时花费的医师时间：一项描述性研究。

背景技术提供者使用电子健康记录（EHR）支持护理交付过程所花费的时间是美国医疗保健系统关注的问题。考虑到对患者护理的潜在影响以及与此相关的高昂费用，特别是对于工作主要是认知的医学专家，这些发现需要更准确的文献记录，以证明医生对这些以临床为重点的EHR功能的投入时间。目的描述美国多个医疗提供系统中的门诊医疗专科医生和基层医疗医生在各种EHR功能上花费的时间。设计描述性研究。使用Cerner Millennium EHR设置以美国为基础的成人，非手术，门诊实践。参与者155 000美国医师。测量数据是在2018年从Lights On Network（Cerner）中的软件日志文件中提取的，这些数据总计花费了13种以临床为重点的EHR功能中的每一个所花费的时间。计算每门专业的平均遭遇。结果这项研究包括来自417个卫生系统的约15,000名医生的约1亿例患者的数据。每次使用EHR，医生平均每次会花费16分钟14秒，图表检查（33％），文档（24％）和订购（17％）功能占大部分时间。提供者使用EHR花费的时间分布在各个专业中差异很大。在各个专业中，花在各种临床上集中的功能上的时间比例是相似的。限制无法检查按卫生系统划分的差异，所有提供者都使用相同的软件。结论使用EHR来支持护理服务所花费的时间构成了医生一天的大部分时间，并且差异很大，这表明有机会优化系统和流程。主要资金来源无。