Study: Family physicians spend up to 33 hours in monthly EHR overtime

By Jackie Drees for Becker’s Hospital Review

The amount of time family physicians spend working in the EHR after hours can vary widely, ranging from zero to 33 hours each month, according to a study published in the Family Medicine February 2020 journal issue.

University of Arizona College of Medicine researchers analyzed EHR use of 24 family medicine trainees and 10 family medicine physician faculty members at the Phoenix-based institution for the six-month study. The family medicine trainees were postgraduate years one through three, and the study period lasted from January 2017 to June 2017 following UA’s September 2016 Cerner EHR implementation.

For the study, the research team collected and examined data on time spent in the EHR using Cerner Advance, the company’s web-based application that collects and presents user-specific usage data for time spent in the EHR. The researchers collected the following data points: number of patients seen, total time per patient and total time spent after hours. All resident patient encounters had an attributed supervision faculty physician, which prevented the researchers from collecting full data for faculty members.

Active EHR time was defined as three or more mouse clicks per minute, 15 or more keystrokes per minute and/or 1,700 or more mouse pixels per minute of mouse movement. EHR after-hours use was defined as time spent between 6:00 p.m. and 6:00 a.m. and/or time spent on the weekends.

Results of the study varied, with total time after hours per month ranging from 0.9 to 26 hours within the postgraduate year three cohort; 0.3 to 33.7 hours within the postgraduate year two cohort; zero to 10.9 hours within the postgraduate year one cohort; and zero to 28.2 hours within the faculty cohort.

Study authors noted two major limitations with the analysis: the proximity of the study period to an EHR transition and the limited ability to measure faculty EHR time. The researchers concluded that the variation in EHR overtime continued regardless of the level of system training.