SAN FRANCISCO — Adopting an electronic health records system reduced the mean length of visits at five outpatient clinics by 4 minutes per patient, a difference that was not statistically significant but that should allay physicians' fears that the technology might be a burden, Lisa Pizziferri said.
The results come from a time-motion study in which observers shadowed primary care physicians before and after implementation of the electronic health records (EHR) system, she said at the triennial congress of the International Medical Informatics Association.
They studied 20 doctors before EHR implementation, 16 of those after adoption of the system, and 4 physicians recruited after EHR implementation, for a total of 20 physicians before and after the change.
Direct patient care took about 14 minutes in the pre-EHR era and 13 minutes using EHR, said Ms. Pizziferri of Partners HealthCare System Inc., Wellesley, Mass.
Indirect patient care—reading, writing, or other tasks in support of direct patient care—took 9 minutes before EHR and 10 minutes after. Physicians spent about half a minute reviewing schedules before EHR and 1 minute with EHR. Time spent eating, walking, or performing other miscellaneous tasks decreased from 4 minutes to 3 minutes per patient after EHR implementation.
The mean overall time spent with each patient decreased by 4 minutes, and was calculated independently, not by adding up the times of individual tasks, she said. During an average 4-hour observation period per physician, physicians saw 9 patients while using paper records and 10 patients while using EHR.
Asked to rate their experiences on a five-point scale (with five being the best), physicians rated the EHRs impact on quality, access, and communication a four, Ms. Pizziferri said. Impact on workload was 3 and overall satisfaction, 4.
Partners HealthCare designed the Web-based EHR system, called the Longitudinal Medical Record. It includes clinical data, computerized decision support, reminders for health maintenance, and tools for charting, order entry, and management of results or referrals.