National Trends in Daily Ambulatory Electronic Health Record Use by Otolaryngologists

Objective: Since their development in the 1970s electronic health records (EHRs) are now nearly ubiquitous. This study aims to characterize the daily interactions of otolaryngology providers with EHRs. Methods: This study was a cross-sectional review of provider efficiency profile (PEP) data, as collected by a major EHR vendor. Participating institutions had 6 months of de-identified PEP data reviewed starting January 1, 2019. PEP data is generated for providers with scheduled patients, both attendings and advanced practice providers (APPs). Time metrics are recorded when a provider is interacting with the EHR including a 5-second time-out for inactivity. Results: Data on 269 otolaryngologists and 29 APPs from 10 institutions were evaluated. On scheduled ambulatory clinic days attendings spent 70 ± 36 (mean ± standard deviation) min interacting in the EHR versus 108 ± 46 min for APPs. Of the daily EHR time, mean time in notes, clinical review, in basket, orders, and schedule were 30.1 ± 19.4, 9.6 ± 6.1, 7.3 ± 5.8, and 5.8 ± 7.6 min, respectively. Per patient visit, median (interquartile range) time in notes, clinical review, and orders were 3.19 (2.2–4.9), 1.14 (0.63–1.8), and 0.70 (0.47–1.05) min, respectively. Mean progress note length was 4638 ± 2143 characters. Conclusion: Otolaryngology providers spend a meaningful portion of their clinic day interacting with the EHR. PEP data may provide means to target interventions and a metric to measure the impact of those interventions on provider EHR efficiency. Level of Evidence: 3 Laryngoscope, 131:975–981, 2021.