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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 1,170)
  • 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
54 news outlets
blogs
5 blogs
policy
1 policy source
twitter
396 tweeters
facebook
7 Facebook pages
googleplus
2 Google+ users

Citations

dimensions_citation
53 Dimensions

Readers on

mendeley
130 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 396 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 130 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 130 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 26 20%
Student > Ph. D. Student 21 16%
Unspecified 20 15%
Student > Master 13 10%
Other 12 9%
Other 38 29%
Readers by discipline Count As %
Medicine and Dentistry 55 42%
Unspecified 29 22%
Computer Science 15 12%
Nursing and Health Professions 7 5%
Engineering 5 4%
Other 19 15%

Attention Score in Context

This research output has an Altmetric Attention Score of 720. 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 18 March 2019.
All research outputs
#6,799
of 12,667,610 outputs
Outputs from Annals of Family Medicine
#3
of 1,170 outputs
Outputs of similar age
#363
of 265,581 outputs
Outputs of similar age from Annals of Family Medicine
#1
of 19 outputs
Altmetric has tracked 12,667,610 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 1,170 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 28.3. 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 265,581 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.