The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review

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Background

This article is a review of literature which evaluates the consequences of charting time in an EHR by clinicians such as doctors and nurses. It reviews what factors affected the efficiency and differences in the documentation times. Over 20 papers were reviewed and differences such as types of documentation, such as bedside or point of care systems were compared. [1]

Methods

The researchers reviewed hundreds of articles that contained the terms EHRs and workflow. The publications also had to have the following:

  • Comparison group as part of the study design
  • Documentation times as part of the outcomes
  • Time differences quantified and estimated
  • Subjects were health care workers
  • Study site had to be a home, clinic, or hospital

Initially there where 628 abstracts selected, out of the selected 63 papers were selected from the 628. Forty papers failed to meet minimum necessities for review, the most typical being unobtainable being or limited information on methodology.

Results

Generally, all the studies showed some decrease in documentation time for nurses and an increase for physicians. The differences in type of documentation between physicians and nurses was cited as one of the reasons for this variation.

Conclusion

Efficiency of documenting in EHRs need to be assessed from the different user's perspective. Because documenting in templates, CPOE, or care plans can differ by physicians and nurses, it should be evaluated seperately.

Comments

I agree that nursing and physician measurement of efficiency in documentation should be measured independently.

This article was conducted to review the differences in time between paper and electronic charting for nurses and physicians. Nursing staff is usually at one place and performs all their documentation in which ever method they are utilizing. Physicians are mobile and may not have the same time to practice and become as familiar to documenting electronically. One of the common key points in most of the reviews is the importance of physician training not only during implementation, but also after EHR has been established. Efficiency can be achieved if users are properly trained.

References

  1. Poissant, L., PhD, Pereira, J., MSc, Tamblyn, R., PhD, Kawasumi, Y., MSc (2005). The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review. Journal of American Medical Informatics Association, 12, 505-516. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1205599/