In the United States, the electronic health record (EHR) has become increasingly prevalent in the day-to-day practice of physicians, with primary care physicians (PCPs) spending the most time in the EHR. Yet, the association between time spent in the EHR and quality of ambulatory care was unclear before Brigham and Women’s researchers investigated this critical intersection. In their cross-sectional study of 291 primary care physicians, the team tracked ambulatory quality measures (year-end, PCP panel-level achievement of targets for hemoglobin A1C level control, lipid management, hypertension control, diabetes screening, and breast cancer screening) and found a significant, positive relationship between EHR time and some of these measures — panel-wide hemoglobin A1C level control, hypertension control, and breast cancer screening. These associations suggest that extra time spent in the EHR may benefit certain care outcomes, particularly for doctors who spend less than half their time seeing patients.
“Although increased EHR time is associated with burnout, it may represent a level of thoroughness or communication that enhances certain outcomes,” said lead author Lisa Rotenstein, MD, MBA, of the Primary Care Center of Excellence at the Brigham. “It may be useful for future studies to characterize payment models, workflows, and technologies that enable high-quality ambulatory care delivery while minimizing EHR burden.”