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

The DOI matches its Crossref record; 44 of the 45 references it cites were found in a registry or an index.

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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Crossref · 10.1016/j.healthpol.2018.05.014

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Metadata

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
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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