Does Physician's Choice of When to Perform EHR Tasks Influence Total EHR Workload?

54 Pages Posted: 7 Feb 2023 Last revised: 27 Nov 2023

See all articles by Umit Celik

Umit Celik

University of North Carolina (UNC) at Chapel Hill - Kenan-Flagler Business School

Sandeep Rath

University of North Carolina (UNC) at Chapel Hill - Kenan-Flagler Business School

Saravanan Kesavan

University of North Carolina Kenan-Flagler Business School

Bradley R. Staats

University of North Carolina Kenan-Flagler Business School

Date Written: January 12, 2023

Abstract

Problem definition: Physicians spend more than 5 hours a day working on Electronic Health Record
(EHR) systems and more than an hour doing EHR tasks after the end of the workday. Numerous studies have identified the detrimental effects of excessive EHR use and after-hours work, including physician burnout, physician attrition, and appointment delays. However, EHR time is not purely an exogenous factor as it depends on physician usage behavior that could have important operational consequences. Interestingly, prior literature has not considered this topic rigorously. In this paper, we investigate how physicians' workflow decisions on when to perform EHR tasks affect: (1) total time on EHR and (2) time spent after work.

Methodology/Results: Our data comprise around 150,000 appointments from 74 physicians from a large Academic Medical Center Family Medicine unit. Our dataset contains detailed, process-level time stamps of appointment progression and EHR use. We find that the effect of working on EHR systems depends on whether the work is done before or after an appointment. Pre-appointment EHR work reduces total EHR workload and after-work hours spent on EHR. Post-appointment EHR work reduces after-work hours on EHR but increases total EHR time. We find that increasing idle time between appointments can encourage both pre- and post-appointment EHR work.

Managerial implications: Our results not only help us understand the timing and structure of work on secondary tasks, more generally, but also will help healthcare administrators create EHR workflows and appointment schedules to reduce physician burnout associated with excessive EHR use.

Keywords: Electronic Health Record (EHR); task-switching; healthcare operations; service operations

Suggested Citation

Celik, Umit and Rath, Sandeep and Kesavan, Saravanan and Staats, Bradley R., Does Physician's Choice of When to Perform EHR Tasks Influence Total EHR Workload? (January 12, 2023). Available at SSRN: https://ssrn.com/abstract=4323956 or http://dx.doi.org/10.2139/ssrn.4323956

Umit Celik (Contact Author)

University of North Carolina (UNC) at Chapel Hill - Kenan-Flagler Business School ( email )

Chapel Hill, NC 27599
United States

Sandeep Rath

University of North Carolina (UNC) at Chapel Hill - Kenan-Flagler Business School ( email )

McColl Building
Chapel Hill, NC 27599-3490
United States

Saravanan Kesavan

University of North Carolina Kenan-Flagler Business School ( email )

300 Kenan Center Drive
Chapel Hill, NC 27599
United States

Bradley R. Staats

University of North Carolina Kenan-Flagler Business School ( email )

McColl Building, CB#3490
Chapel Hill, NC 27599
United States

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