Cited by 320Electronic Health Records SystemsNursing Diagnosis and DocumentationMedical Coding and Health Information

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The impact of electronic health record systems on clinical documentation times: A systematic review

Baumann, Lisa Ann, Baker, Jannah, Elshaug, Adam G.·2018·Health Policy

DOI 10.1016/j.healthpol.2018.05.014

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Abstract

Background Effective management of hospital staff time is crucial to quality patient care. Recent years have seen widespread implementation of electronic health record (EHR) systems but the effect of this on documentation time is unknown. This review compares time spent on documentation tasks by hospital staff (physicians, nurses and interns) before and after EHR implementation.Methods A systematic search identified 8153 potentially relevant citations. Studies examining proportion of total workload spent on documentation with ≥40 h of staff observation time were included. Meta-analysis was performed for physicians, nurses and interns comparing pre- and post-EHR results. Studies were weighted by person-hours observation time.Results Twenty-eight studies met selection criteria. Seventeen were pre-EHR, nine post-EHR and two examined both periods. With implementation of EHR, physicians' documentation time increased from 16% (95% confidence interval (CI) 11-22%) to 28% (95% CI 19-37%), nurses from 9% (95% CI 6-12%) to 23% (95% CI 15-32%) and interns from 20% (95% CI 7-32%) to 26% (95% CI 10-42%).Conclusions There is a lack of long-term follow-up on the effects of EHR implementation. Initial adjustment to EHR appears to increase documentation time but there is some evidence that as staff become more familiar with the system, it may ultimately improve work flow.

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Authors: Baumann, L. A., Baker, J., & Elshaug, A. G.
Affiliations: University of Bremen (DE)
The University of Sydney (AU)
Corresponding author: Elshaug, Adam G.
ORCID: Baumann, Lisa Ann
Baker, Jannah
Elshaug, Adam G.
Venue: Health Policy
Publisher: Elsevier BV
Published: 2018-08
Volume: 122
Issue: 8
Pages: 827-836
ISSN: 0168-8510 (ISSN-L)
DOI: 10.1016/j.healthpol.2018.05.014
OpenAlex: W2805432200
Cited by: 320
References: 45
Citations by year: 2026: 37 · 2025: 47 · 2024: 52 · 2023: 42 · 2022: 45 · 2021: 45 · 2020: 27 · 2019: 22 · 2018: 1
FWCI: 4.43
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Health Policy (publishedVersion)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Funders: HCF Research Foundation Professorial Research Fellow
Topics: Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Health Sciences › Nursing › Research and Theory › Nursing Diagnosis and Documentation
Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
Keywords: electronic health records, physician documentation, nursing documentation, medical interns, hospital staff workload, EHR implementation
MeSH terms: Documentation, Patient Care, Hospitals, Humans, Patient Care Team, Quality of Health Care, Time Factors, Workload, Electronic Health Records

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The impact of electronic health record systems on clinical documentation times: A systematic review

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