Interaction time with electronic health records: a systematic review
Open accessAbstract
BACKGROUND: The amount of time that health care clinicians (physicians and nurses) spend interacting with the electronic health record is not well understood. OBJECTIVE: This study aimed to evaluate the time that health care providers spend interacting with electronic health records (EHR). METHODS: Data are retrieved from Ovid MEDLINE(R) and Epub Ahead of Print, In-Process and Other Non-Indexed Citations and Daily, (Ovid) Embase, CINAHL, and SCOPUS. STUDY ELIGIBILITY CRITERIA: Peer-reviewed studies that describe the use of EHR and include measurement of time either in hours, minutes, or in the percentage of a clinician's workday. Papers were written in English and published between 1990 and 2021. PARTICIPANTS: All physicians and nurses involved in inpatient and outpatient settings. STUDY APPRAISAL AND SYNTHESIS METHODS: A narrative synthesis of the results, providing summaries of interaction time with EHR. The studies were rated according to Quality Assessment Tool for Studies with Diverse Designs. RESULTS: Out of 5,133 de-duplicated references identified through database searching, 18 met inclusion criteria. Most were time-motion studies (50%) that followed by logged-based analysis (44%). Most were conducted in the United States (94%) and examined a clinician workflow in the inpatient settings (83%). The average time was nearly 37% of time of their workday by physicians in both inpatient and outpatient settings and 22% of the workday by nurses in inpatient settings. The studies showed methodological heterogeneity. CONCLUSION: This systematic review evaluates the time that health care providers spend interacting with EHR. Interaction time with EHR varies depending on clinicians' roles and clinical settings, computer systems, and users' experience. The average time spent by physicians on EHR exceeded one-third of their workday. The finding is a possible indicator that the EHR has room for usability, functionality improvement, and workflow optimization.
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Some physicians spend more than 50% of their time using 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 [3]
Electronic Health Records have substantially increased clinicians' documentation workload.
“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 [3]
This behavior is consistent with prior studies underscoring documentation burden in clinical workflows.
“This behavior is consistent with prior studies underscoring documentation burden in clinical workflows [3].”
From Implementation of large language models in electronic health records (2025) · cites this paper as [3]
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- Authors
- Pinevich, Y., Clark, K. J., Harrison, A. M., Pickering, B. W., & Herasevich, V.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Pinevich, Yuliya
- Venue
- Applied Clinical Informatics
- Publisher
- Georg Thieme Verlag KG
- Published
- 2021-08
- Volume
- 12
- Issue
- 04
- Pages
- 788-799
- ISSN
- 1869-0327 (ISSN-L)
- PMC
- PMC8387128
- OpenAlex
- W3195193001
- Cited by
- 62
- References
- 78
- Citations by year
- 2026: 16 · 2025: 23 · 2024: 5 · 2023: 8 · 2022: 7 · 2021: 3
- FWCI
- 1.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Applied Clinical Informatics (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Nursing › Issues, ethics and legal aspects › Nursing Diagnosis and Documentation
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- electronic health records, physician workload, nursing workload, EHR usability, clinical workflow, time and motion study, inpatient care, outpatient care
- MeSH terms
- Delivery of Health Care, Health Personnel, Humans, Physicians, Workflow, Electronic Health Records
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