Abstract Details

Title Time Spent in the Electronic Health Record by Neurologists: Analyzing daily use inside and outside the clinic using EPIC Signal data

Topic Practice, Policy, and Ethics

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 453

Objective To quantify how long neurologists spend in the electronic health record (EHR).

Background

Neurologists have extensive information needs for decision-making (e.g., neuroimaging, video-recordings) that are likely to affect time spent in the EHR. While EHR-related burden is being increasingly studied due to the national spotlight on physician burnout, few studies have focused on neurology.

Design/Methods Data were obtained using Epic Signal, which provides detailed data on how long clinicians spent on different EHR interfaces. We focused on all neurologists from an academic health system in Florida who practiced during November 2019 to October 2020 inclusive. Our EHR outcome measures were time spent interacting with the EHR, time spent in the EHR outside scheduled clinic hours, inbox management, writing notes, and chart review. We reported the median and range of outcome measures because they had skewed distributions. We also assessed whether changes related to the coronavirus pandemic (e.g., telemedicine adoption) were associated with differences in EHR use via Wilcoxon signed-rank tests.

Results Our sample contained 2,286 physician-week observations (83 neurologists). They spent up to: 333.6 minutes/day (median:66.5, range:0.5-333.6) interacting with the EHR, 303.4 minutes/day (median:27.8, range:0.0-303.4) in the EHR outside scheduled hours, 45.6 minutes/day (median:3.4, range:0.0-45.6) in the In Basket, 240.3 minutes/day (median:31.1, range:0.0-240.3) writing notes, and 73.1 minutes/day (median:11.0, range:0.0-73.1) in clinical review. EHR measures were comparable before and during the pandemic.

Conclusions Similar to physicians in other specialties, neurologists spend a significant proportion of their clinical effort engaged with the EHR. Neurologists may benefit from interventions that reduce time spent in the EHR, such as after-hours EHR use and documentation.

Authors/Disclosures
Oliver Nguyen PRESENTER	Oliver Nguyen has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Adolfo Ramirez Zamora, MD (University of Louisville)	Dr. Ramirez Zamora has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerevel therapeutics. Dr. Ramirez Zamora has received personal compensation in the range of $0-$499 for serving as a Consultant for NeuroPacs. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Iota Inc. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Maplight. Dr. Ramirez Zamora has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. The institution of Dr. Ramirez Zamora has received research support from Parkinsons Foundation.
Irene Malaty, MD, FAAN (University of Florida)	Dr. Malaty has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Malaty has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aevum. The institution of Dr. Malaty has received research support from Abbvie. The institution of Dr. Malaty has received research support from Revance. The institution of Dr. Malaty has received research support from Parkinson Foundation. The institution of Dr. Malaty has received research support from SAGE. The institution of Dr. Malaty has received research support from Emalex. The institution of Dr. Malaty has received research support from Acadia. Dr. Malaty has received publishing royalties from a publication relating to health care. Dr. Malaty has received personal compensation in the range of $500-$4,999 for serving as a Speaker & Center of Excellence Director with Parkinson Foundation. Dr. Malaty has a non-compensated relationship as a MAB member & Center of Excellence Directory with Tourette Association of America that is relevant to AAN interests or activities.

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