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Appl Clin Inform 2021; 12(05): 1082-1090
DOI: 10.1055/s-0041-1739519
Research Article

Evaluating Electronic Health Record Limitations and Time Expenditure in a German Medical Center

Tom de Hoop
1   Innovation Center Computer Assisted Surgery, Institute at the Faculty of Medicine, Leipzig University, Leipzig, Germany
,
Thomas Neumuth
1   Innovation Center Computer Assisted Surgery, Institute at the Faculty of Medicine, Leipzig University, Leipzig, Germany
› Author Affiliations Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Abstract

Objectives This study set out to obtain a general profile of physician time expenditure and electronic health record (EHR) limitations in a large university medical center in Germany. We also aim to illustrate the merit of a tool allowing for easier capture and prioritization of specific clinical needs at the point of care for which the current study will inform development in subsequent work.

Methods Nineteen physicians across six different departments participated in this study. Direct clinical observations were conducted with 13 out of 19 physicians for a total of 2,205 minutes, and semistructured interviews were conducted with all participants. During observations, time was measured for larger activity categories (searching information, reading information, documenting information, patient interaction, calling, and others). Semistructured interviews focused on perceived limitations, frustrations, and desired improvements regarding the EHR environment.

Results Of the observed time, 37.1% was spent interacting with the health records (9.0% searching, 7.7% reading, and 20.5% writing), 28.0% was spent interacting with patients corrected for EHR use (26.9% of time in a patient's presence), 6.8% was spent calling, and 28.1% was spent on other activities. Major themes of discontent were a spread of patient information, high and often repeated documentation burden, poor integration of (new) information into workflow, limits in information exchange, and the impact of such problems on patient interaction. Physicians stated limited means to address such issues at the point of care.

Conclusion In the study hospital, over one-third of physicians' time was spent interacting with the EHR, environment, with many aspects of used systems far from optimal and no convenient way for physicians to address issues as they occur at the point of care. A tool facilitating easier identification and registration of issues, as they occur, may aid in generating a more complete overview of limitations in the EHR environment.

Keywords

human–computer interaction - satisfaction - electronic health records and systems - workflow - physician workload

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, and was waived by the Institutional Review Board of the university medical center Leipzig.


Supplementary Material



Publication History

Received: 12 July 2021

Accepted: 11 October 2021

Article published online:
22 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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