The impact of electronic health record systems on clinical documentation times: A systematic review

•Impact of electronic health record (EHR) use on documentation time was examined.•EHR implementation associated with increased documentation time for hospital staff.•A need for longer follow-up of EHR impact is highlighted.•Multitasking and interruptions to staff work flow is a concern to patient sa...

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Vydáno v:Health policy (Amsterdam) Ročník 122; číslo 8; s. 827 - 836
Hlavní autoři: Baumann, Lisa Ann, Baker, Jannah, Elshaug, Adam G.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Ireland Elsevier B.V 01.08.2018
Elsevier Science Ltd
Témata:
Administrative burden
Citations
Confidence intervals
Criteria
Documentation
Documentation - statistics & numerical data
Efficiency
Electronic health record
Electronic Health Records
Health care policy
Health services
Hospital staff
Hospitals
Humans
Long term
Medical personnel
Medical records
Meta-analysis
Nurses
Patient Care
Patient Care Team - statistics & numerical data
Patients
Physicians
Quality of care
Quality of Health Care
Records management
Selection criteria
Systematic review
Time
Time Factors
Trust
Workload - statistics & numerical data
Administrative burden
Efficiency
Documentation
Systematic review
Electronic health record
Hospital staff
Meta-analysis
ISSN:0168-8510, 1872-6054, 1872-6054
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Shrnutí:•Impact of electronic health record (EHR) use on documentation time was examined.•EHR implementation associated with increased documentation time for hospital staff.•A need for longer follow-up of EHR impact is highlighted.•Multitasking and interruptions to staff work flow is a concern to patient safety.•Adaptation to EHR over time could potentially solve inefficiencies in work flow. Effective management of hospital staff time is crucial to quality patient care. Recent years have seen widespread implementation of electronic health record (EHR) systems but the effect of this on documentation time is unknown. This review compares time spent on documentation tasks by hospital staff (physicians, nurses and interns) before and after EHR implementation. A systematic search identified 8153 potentially relevant citations. Studies examining proportion of total workload spent on documentation with ≥40 h of staff observation time were included. Meta-analysis was performed for physicians, nurses and interns comparing pre- and post-EHR results. Studies were weighted by person-hours observation time. Twenty-eight studies met selection criteria. Seventeen were pre-EHR, nine post-EHR and two examined both periods. With implementation of EHR, physicians’ documentation time increased from 16% (95% confidence interval (CI) 11–22%) to 28% (95% CI 19–37%), nurses from 9% (95% CI 6–12%) to 23% (95% CI 15–32%) and interns from 20% (95% CI 7–32%) to 26% (95% CI 10–42%). There is a lack of long-term follow-up on the effects of EHR implementation. Initial adjustment to EHR appears to increase documentation time but there is some evidence that as staff become more familiar with the system, it may ultimately improve work flow.
Bibliografie:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ObjectType-Evidence Based Healthcare-1
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ISSN:0168-8510
1872-6054
1872-6054
DOI:10.1016/j.healthpol.2018.05.014