Primary care physicians spend an average of 30 percent of patient visit time working in electronic health records (EHRs), according to a study published in Family Medicine.

Meant to streamline the clinical workflow, EHRs often have mixed effects. In this study, researchers evaluated the time required to care for patients in primary care clinics while using EHRs.

“A survey by the Office of the National Coordinator for Health Information Technology in 2014 reported that 87 percent of primary care physicians used electronic health records (EHRs),” wrote first author Richard A. Young, MD, and colleagues. “Reviews of the effect of EHRs on patient and physician outcomes have been mixed, including neutral to small positive effects on common quality metrics and disease-specific guidelines, mixed on office workflow, and mostly decreased on primary care physician productivity.”

Some 982 clinic visits by family physician attendings, residents and patients were directly observed by researchers.  Measures of total visit time, pre-visit chart time, face-to-face time, non-face time, out-of-hours EHR work time and total EHR work time were included in the findings.

Results showed physicians spent an average of 35.8 minutes per visit. During the visit, time spent on EHRs included 2.9 minutes prior to entering the room, 16.5 minutes of face-to-face time, 2 minutes in the room and 7.5 minutes of non-face time. Additionally, 6.9 minutes were spent working on the EHR outside of clinic hours.

“We found that family physicians spent more time in direct ambulatory patient care working in the EHR than they spent in face-to-face time with their patients,” concluded Young and colleagues. “The majority of family physicians worked through lunch, stayed late at clinic, or took their work home to complete the day’s EHR work.”