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Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations

Overview of attention for article published in Annals of Family Medicine, September 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#3 of 1,194)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

news
58 news outlets
blogs
7 blogs
policy
2 policy sources
twitter
411 tweeters
facebook
7 Facebook pages
googleplus
2 Google+ users

Citations

dimensions_citation
71 Dimensions

Readers on

mendeley
156 Mendeley
citeulike
1 CiteULike
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Title
Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations
Published in
Annals of Family Medicine, September 2017
DOI 10.1370/afm.2121
Pubmed ID
Authors

Brian G. Arndt, John W. Beasley, Michelle D. Watkinson, Jonathan L. Temte, Wen-Jan Tuan, Christine A. Sinsky, Valerie J. Gilchrist

Abstract

Primary care physicians spend nearly 2 hours on electronic health record (EHR) tasks per hour of direct patient care. Demand for non-face-to-face care, such as communication through a patient portal and administrative tasks, is increasing and contributing to burnout. The goal of this study was to assess time allocated by primary care physicians within the EHR as indicated by EHR user-event log data, both during clinic hours (defined as 8:00 am to 6:00 pm Monday through Friday) and outside clinic hours. We conducted a retrospective cohort study of 142 family medicine physicians in a single system in southern Wisconsin. All Epic (Epic Systems Corporation) EHR interactions were captured from "event logging" records over a 3-year period for both direct patient care and non-face-to-face activities, and were validated by direct observation. EHR events were assigned to 1 of 15 EHR task categories and allocated to either during or after clinic hours. Clinicians spent 355 minutes (5.9 hours) of an 11.4-hour workday in the EHR per weekday per 1.0 clinical full-time equivalent: 269 minutes (4.5 hours) during clinic hours and 86 minutes (1.4 hours) after clinic hours. Clerical and administrative tasks including documentation, order entry, billing and coding, and system security accounted for nearly one-half of the total EHR time (157 minutes, 44.2%). Inbox management accounted for another 85 minutes (23.7%). Primary care physicians spend more than one-half of their workday, nearly 6 hours, interacting with the EHR during and after clinic hours. EHR event logs can identify areas of EHR-related work that could be delegated, thus reducing workload, improving professional satisfaction, and decreasing burnout. Direct time-motion observations validated EHR-event log data as a reliable source of information regarding clinician time allocation.

Twitter Demographics

The data shown below were collected from the profiles of 411 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 156 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 156 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 31 20%
Unspecified 26 17%
Student > Ph. D. Student 23 15%
Student > Master 17 11%
Other 15 10%
Other 43 28%
Unknown 1 <1%
Readers by discipline Count As %
Medicine and Dentistry 62 40%
Unspecified 33 21%
Computer Science 17 11%
Nursing and Health Professions 11 7%
Engineering 7 4%
Other 25 16%
Unknown 1 <1%

Attention Score in Context

This research output has an Altmetric Attention Score of 778. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 June 2019.
All research outputs
#6,235
of 13,090,583 outputs
Outputs from Annals of Family Medicine
#3
of 1,194 outputs
Outputs of similar age
#311
of 267,302 outputs
Outputs of similar age from Annals of Family Medicine
#1
of 19 outputs
Altmetric has tracked 13,090,583 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,194 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 29.4. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 267,302 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 19 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.