Electronic health records in specialty care: A time-motion study
Electronic health records in specialty care: A time-motion study
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DOI：
10.1197/jamia.m2318
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发表时间：
2007-09-01
影响因子：
6.4
通讯作者：
Bates, David W.
中科院分区：
文献类型：
--
作者：
Lo, Helen G.;Newmark, Lisa P.;Bates, David W.
背景：电子病历在提高医疗安全、质量和效率方面具有巨大潜力。然而，采用一直很缓慢，一个主要的担忧是临床医生将需要更多的时间来完成他们使用EHR的工作。目的：评估使用电子健康记录对专科医生时间的影响。设计：前瞻性试验前后，在四个专科诊所的综合交付系统：心脏病、皮肤科、内分泌和疼痛，电子健康记录对主治医生时间的影响。测量：我们使用时间运动方法来测量医生在85项指定活动中的一项所花费的时间。结果：在从纸质记录转向基于网络的动态电子健康记录之前和之后，对主治医生进行了监测。在所有专科中，观察到15名医生在仍使用纸质记录的情况下治疗157名患者，并观察到15名医生在采用后治疗146名患者。实施电子健康记录后，所有专科的每位患者平均调整后的总时间略有增加(Delta=0.94min，p=0.83)，从28.8分钟(SE=3.6)增加到29.8分钟(SE=3.6)。结论：实施电子健康记录对专科诊所的整体就诊时间影响不大。
Background: Electronic health records (EHRs) have great potential to improve safety, quality, and efficiency in medicine. However, adoption has been slow, and a key concern has been that clinicians will require more time to complete their work using EHRs. Most previous studies addressing this issue have been done in primary care.Objective: To assess the impact of using an EHR on specialists' time.Design: Prospective, before-after trial of the impact of an EHR on attending physician time in four specialty clinics at an integrated delivery system: cardiology, dermatology, endocrine, and pain.Measurements: We used a time-motion method to measure physician time spent in one of 85 designated activities.Results: Attending physicians were monitored before and after the switch from paper records to a web-based ambulatory EHR. Across all specialties, 15 physicians were observed treating 157 patients while still using paper-based records, and 15 physicians were observed treating 146 patients after adoption. Following EHR implementation, the average adjusted total time spent per patient across all specialties increased slightly but not significantly (Delta = 0.94 min., p = 0.83) from 28.8 (SE = 3.6) to 29.8 (SE = 3.6) min.Conclusion: These data suggest that implementation of an EHR had little effect on overall visit time in specialty clinics.