Appl Clin Inform 2021; 12(04): 788-799
DOI: 10.1055/s-0041-1733909
Review Article

Interaction Time with Electronic Health Records: A Systematic Review

Yuliya Pinevich
1   Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States
Kathryn J. Clark
1   Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States
Andrew M. Harrison
2   Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, United States
Brian W. Pickering
1   Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States
Vitaly Herasevich
1   Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States
› Author Affiliations
Funding None.


Background The amount of time that health care clinicians (physicians and nurses) spend interacting with the electronic health record is not well understood.

Objective This study aimed to evaluate the time that health care providers spend interacting with electronic health records (EHR).

Methods Data are retrieved from Ovid MEDLINE(R) and Epub Ahead of Print, In-Process and Other Non-Indexed Citations and Daily, (Ovid) Embase, CINAHL, and SCOPUS.

Study Eligibility Criteria Peer-reviewed studies that describe the use of EHR and include measurement of time either in hours, minutes, or in the percentage of a clinician's workday. Papers were written in English and published between 1990 and 2021.

Participants All physicians and nurses involved in inpatient and outpatient settings.

Study Appraisal and Synthesis Methods A narrative synthesis of the results, providing summaries of interaction time with EHR. The studies were rated according to Quality Assessment Tool for Studies with Diverse Designs.

Results Out of 5,133 de-duplicated references identified through database searching, 18 met inclusion criteria. Most were time-motion studies (50%) that followed by logged-based analysis (44%). Most were conducted in the United States (94%) and examined a clinician workflow in the inpatient settings (83%). The average time was nearly 37% of time of their workday by physicians in both inpatient and outpatient settings and 22% of the workday by nurses in inpatient settings. The studies showed methodological heterogeneity.

Conclusion This systematic review evaluates the time that health care providers spend interacting with EHR. Interaction time with EHR varies depending on clinicians' roles and clinical settings, computer systems, and users' experience. The average time spent by physicians on EHR exceeded one-third of their workday. The finding is a possible indicator that the EHR has room for usability, functionality improvement, and workflow optimization.

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects.

Supplementary Material

Publication History

Received: 04 May 2021

Accepted: 03 July 2021

Article published online:
25 August 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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