Assessing the Impact of EHR Documentation Burden on Health Information Exchange Use

Presentation Time: 11:45 AM - 12:00 PM

Abstract Keywords: Documentation Burden, Interoperability and Health Information Exchange, Causal Inference, Workflow
Primary Track: Applications
Programmatic Theme: Clinical Informatics

While electronic health record (EHR) documentation burden is known to be associated with reduced clinician well-being and burnout, it may have even worse unintended consequences if documentation work also crowds out other high-value EHR tasks. We examine this novel question by assessing the relationship between documentation burden and a high-value but optional EHR task – use of health information exchange (HIE) to view patient records from outside organizations. Our study takes advantage of an exogenous shock to documentation time, appointment no-shows. We find that documentation time has a strong impact on HIE use, with each additional hour spent documenting resulting in a 7.1 percent reduction in the proportion of a patients with an outside record viewed by the physician seeing them that day. This crowd out effect may explain why the US has yet to realize broad benefits from HIE and could also be true for other high-value EHR and non-EHR tasks as busy physicians simply lack time to incorporate them into their workflows. Our results point to the urgent need for policymakers to do more to reduce documentation burden.

Speaker(s):
A J Holmgren, PhD
University of California, San Francisco

Author(s):
Julia Adler-Milstein, PhD - UCSF School of Medicine; Nate Apathy, PhD - University of Maryland;