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
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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“physicians spend more time documenting since the introduction of Electronic Health Records (EHRs), with some spending more than 50% of their time using EHRs [3,4].”
From Implementation of large language models in electronic health records (2025) · cites this paper as [4]
In the citing paper
“with some spending more than 50% of their time using EHRs [3,4].”
From Implementation of large language models in electronic health records (2025) · cites this paper as [4]
Citations
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Tsai, C. H., Eghdam, A., Davoody, N., Wright, G., Flowerday, S., & Koch, S. (2020) · Life · doi:10.3390/life10120327 · Cited by 305
Will Generative Artificial Intelligence Deliver on Its Promise in Health Care?
Wachter, R. M., & Brynjolfsson, E. (2023) · JAMA · doi:10.1001/jama.2023.25054 · Cited by 206
Metrics for assessing physician activity using electronic health record log data
Sinsky, C. A., Rule, A., Cohen, G., Arndt, B. G., Shanafelt, T. D., Sharp, C. D., Baxter, S. L., Tai-Seale, M., Yan, S., Chen, Y., et al. (2020) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocz223 · Cited by 162
Asgari, E., Kaur, J., Nuredini, G., Balloch, J., Taylor, A. M., Sebire, N., Robinson, R., Peters, C., Sridharan, S., & Pimenta, D. (2024) · JMIR Medical Informatics · doi:10.2196/55499 · Cited by 142
Ebbers, T., Kool, R. B., Smeele, L. E., Dirven, R., den Besten, C. A., Karssemakers, L. H. E., Verhoeven, T., Herruer, J. M., van den Broek, G. B., & Takes, R. P. (2022) · Journal of Medical Systems · doi:10.1007/s10916-022-01837-9 · Cited by 144
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.
- Venue
- Health Policy
- Publisher
- Elsevier BV
- Published
- 2018-08
- Volume
- 122
- Issue
- 8
- Pages
- 827-836
- ISSN
- 0168-8510 (ISSN-L)
- 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
- 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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