{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T08:15:52Z","timestamp":1778314552920,"version":"3.51.4"},"reference-count":93,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T00:00:00Z","timestamp":1610409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"US National Library of Medicine of the National Institutes of Health","award":["5T15LM007079"],"award-info":[{"award-number":["5T15LM007079"]}]},{"DOI":"10.13039\/100000056","name":"National Institute for Nursing Research","doi-asserted-by":"crossref","award":["1R01NR016941"],"award-info":[{"award-number":["1R01NR016941"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000056","name":"National Institute for Nursing Research","doi-asserted-by":"crossref","award":["5T32NR007969"],"award-info":[{"award-number":["5T32NR007969"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\u2002<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Electronic health records (EHRs) are linked with documentation burden resulting in clinician burnout. While clear classifications and validated measures of burnout exist, documentation burden remains ill-defined and inconsistently measured. We aim to conduct a scoping review focused on identifying approaches to documentation burden measurement and their characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Extension for Scoping Reviews (ScR) guidelines, we conducted a scoping review assessing MEDLINE, Embase, Web of Science, and CINAHL from inception to April 2020 for studies investigating documentation burden among physicians and nurses in ambulatory or inpatient settings. Two reviewers evaluated each potentially relevant study for inclusion\/exclusion criteria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 3482 articles retrieved, 35 studies met inclusion criteria. We identified 15 measurement characteristics, including 7 effort constructs: EHR usage and workload, clinical documentation\/review, EHR work after hours and remotely, administrative tasks, cognitively cumbersome work, fragmentation of workflow, and patient interaction. We uncovered 4 time constructs: average time, proportion of time, timeliness of completion, activity rate, and 11 units of analysis. Only 45.0% of studies assessed the impact of EHRs on clinicians and\/or patients and 40.0% mentioned clinician burnout.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Standard and validated measures of documentation burden are lacking. While time and effort were the core concepts measured, there appears to be no consensus on the best approach nor degree of rigor to study documentation burden.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Further research is needed to reliably operationalize the concept of documentation burden, explore best practices for measurement, and standardize its use.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocaa325","type":"journal-article","created":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T04:53:26Z","timestamp":1607144006000},"page":"998-1008","source":"Crossref","is-referenced-by-count":224,"title":["Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2756-452X","authenticated-orcid":false,"given":"Amanda J","family":"Moy","sequence":"first","affiliation":[{"name":"Department of Biomedical Informatics, Columbia University, New York, New York, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1457-5724","authenticated-orcid":false,"given":"Jessica M","family":"Schwartz","sequence":"additional","affiliation":[{"name":"School of Nursing, Columbia University, New York, New York, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5281-4143","authenticated-orcid":false,"given":"RuiJun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Columbia University, New York, New York, USA"},{"name":"Department of Translational Data Science and Informatics, Geisinger, Danville, Pennsylvania, USA"}]},{"given":"Shirin","family":"Sadri","sequence":"additional","affiliation":[{"name":"Vagelos School of Physicians and Surgeons, Columbia University New York, New York, USA"}]},{"given":"Eugene","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Columbia University, New York, New York, USA"},{"name":"Department of Medicine, Weill Cornell Medical College, New York, New York, USA"}]},{"given":"Kenrick D","family":"Cato","sequence":"additional","affiliation":[{"name":"School of Nursing, Columbia University, New York, New York, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2632-8867","authenticated-orcid":false,"given":"Sarah Collins","family":"Rossetti","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Columbia University, New York, New York, USA"},{"name":"School of Nursing, Columbia University, New York, New York, USA"}]}],"member":"286","published-online":{"date-parts":[[2021,1,12]]},"reference":[{"issue":"2","key":"2021042419050184800_ocaa325-B1","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1136\/amiajnl-2013-002117","article-title":"Health data use, stewardship, and governance: ongoing gaps and challenges: a report from AMIA\u2019s 2012 health policy meeting","volume":"21","author":"Hripcsak","year":"2014","journal-title":"J Am Med Inform Assoc"},{"issue":"1117","key":"2021042419050184800_ocaa325-B2","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1136\/postgradmedj-2018-135849","article-title":"Unintended consequences of the electronic medical record on physicians in training and their mentors","volume":"94","author":"Paterick","year":"2018","journal-title":"Postgrad Med J"},{"issue":"01","key":"2021042419050184800_ocaa325-B3","doi-asserted-by":"crossref","first-page":"163","DOI":"10.15265\/IY-2016-014","article-title":"The unintended consequences of health information technology revisited","volume":"25","author":"Coiera","year":"2016","journal-title":"Yearb Med Inform"},{"issue":"5","key":"2021042419050184800_ocaa325-B4","doi-asserted-by":"crossref","first-page":"32643","DOI":"10.3402\/jchimp.v6.32643","article-title":"Adoption of electronic health records and barriers","volume":"6","author":"Palabindala","year":"2016","journal-title":"J Community Hosp Intern Med Perspect"},{"issue":"02","key":"2021042419050184800_ocaa325-B5","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1055\/s-0038-1648222","article-title":"Focus section on health IT usability: perceived burden of EHRs on physicians at different stages of their career","volume":"09","author":"Khairat","year":"2018","journal-title":"Appl Clin Inform"},{"issue":"1","key":"2021042419050184800_ocaa325-B6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s11606-012-2192-4","article-title":"Electronic health record impact on work burden in small, unaffiliated, community-based primary care practices","volume":"28","author":"Howard","year":"2013","journal-title":"J Gen Intern Med"},{"issue":"10","key":"2021042419050184800_ocaa325-B7","doi-asserted-by":"crossref","first-page":"742","DOI":"10.7326\/0003-4819-144-10-200605160-00125","article-title":"Systematic review: impact of health information technology on quality, efficiency, and costs of medical care","volume":"144","author":"Chaudhry","year":"2006","journal-title":"Ann Intern Med"},{"issue":"5","key":"2021042419050184800_ocaa325-B8","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1377\/hlthaff.24.5.1103","article-title":"Can electronic medical record systems transform health care? Potential health benefits, savings, and costs","volume":"24","author":"Hillestad","year":"2005","journal-title":"Health Aff"},{"issue":"2","key":"2021042419050184800_ocaa325-B9","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1197\/jamia.M1471","article-title":"Some unintended consequences of information technology in health care: the nature of patient care information system-related errors","volume":"11","author":"Ash","year":"2003","journal-title":"J Am Med Inform Assoc"},{"issue":"1","key":"2021042419050184800_ocaa325-B10","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1056\/NEJMsa0802005","article-title":"Electronic health records in ambulatory care\u2014a national survey of physicians","volume":"359","author":"DesRoches","year":"2008","journal-title":"N Engl J Med"},{"issue":"6","key":"2021042419050184800_ocaa325-B11","first-page":"1072","article-title":"Taming the EHR (electronic health record): there is hope","volume":"3","author":"DiAngi","year":"2016","journal-title":"J Fam Med"},{"issue":"5","key":"2021042419050184800_ocaa325-B12","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1197\/jamia.M1700","article-title":"The impact of electronic health records on time efficiency of physicians and nurses: a systematic review","volume":"12","author":"Poissant","year":"2005","journal-title":"J Am Med Inform Assoc"},{"issue":"6","key":"2021042419050184800_ocaa325-B13","doi-asserted-by":"crossref","first-page":"e97","DOI":"10.1016\/j.jsurg.2018.10.010","article-title":"Documenting or operating: where is time spent in general surgery residency?","volume":"75","author":"Cox","year":"2018","journal-title":"J Surg Educ"},{"issue":"11","key":"2021042419050184800_ocaa325-B14","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1001\/jamainternmed.2018.3956","article-title":"Association of medical scribes in primary care with physician workflow and patient experience","volume":"178","author":"Mishra","year":"2018","journal-title":"JAMA Intern Med"},{"issue":"7","key":"2021042419050184800_ocaa325-B15","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/j.mayocp.2016.05.007","article-title":"Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction","volume":"91","author":"Shanafelt","year":"2016","journal-title":"Mayo Clin Proc"},{"issue":"4","key":"2021042419050184800_ocaa325-B16","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.2196\/medinform.5544","article-title":"Natural language processing-enabled and conventional data capture methods for input to electronic health records: a comparative usability study","volume":"4","author":"Kaufman","year":"2016","journal-title":"JMIR Med Inform"},{"key":"2021042419050184800_ocaa325-B17","author":"Ollapally","year":"2018"},{"key":"2021042419050184800_ocaa325-B18","first-page":"158","article-title":"Persistent paper: the myth of going paperless","volume":"2009","author":"Dykstra","year":"2009","journal-title":"AMIA Annu Symp Proc"},{"issue":"1","key":"2021042419050184800_ocaa325-B19","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1177\/2057158518773906","article-title":"Essential task or meaningless burden? Nurses\u2019 perceptions of the value of documentation","volume":"39","author":"Olivares B\u00f8geskov","year":"2019","journal-title":"Nord J Nurs Res"},{"issue":"2","key":"2021042419050184800_ocaa325-B20","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/01.NCN.0000304775.40531.67","article-title":"Nurses\u2019 perceptions of the impact of electronic health records on work and patient outcomes","volume":"26","author":"Kossman","year":"2008","journal-title":"Comput Inform Nurs"},{"issue":"9","key":"2021042419050184800_ocaa325-B21","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1001\/jama.2017.0076","article-title":"Addressing physician burnout: the way forward","volume":"317","author":"Shanafelt","year":"2017","journal-title":"Jama"},{"issue":"2","key":"2021042419050184800_ocaa325-B22","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1093\/jamiaopen\/ooz003","article-title":"Electronic health record (EHR) training program identifies a new tool to quantify the EHR time burden and improves providers\u2019 perceived control over their workload in the EHR","volume":"2","author":"DiAngi","year":"2019","journal-title":"JAMIA Open"},{"issue":"1","key":"2021042419050184800_ocaa325-B23","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1212\/CPJ.0000000000000209","article-title":"The breadth and burden of data collection in clinical practice","volume":"6","author":"Goldenberg","year":"2016","journal-title":"Neurol Clin Pract"},{"key":"2021042419050184800_ocaa325-B24","year":"2014"},{"issue":"2","key":"2021042419050184800_ocaa325-B25","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1097\/ACM.0000000000001461","article-title":"The impact of administrative burden on academic physicians","volume":"92","author":"Rao","year":"2017","journal-title":"Acad Med"},{"issue":"2","key":"2021042419050184800_ocaa325-B26","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1093\/jamia\/ocy155","article-title":"Clinicians\u2019 reasoning as reflected in electronic clinical note-entry and reading\/retrieval: a systematic review and qualitative synthesis","volume":"26","author":"Colicchio","year":"2019","journal-title":"J Am Med Inform Assoc"},{"issue":"5","key":"2021042419050184800_ocaa325-B27","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1370\/afm.2121","article-title":"Tethered to the EHR: primary care physician workload assessment using EHR event log data and time-motion observations","volume":"15","author":"Arndt","year":"2017","journal-title":"Ann Fam Med"},{"issue":"11","key":"2021042419050184800_ocaa325-B28","doi-asserted-by":"crossref","first-page":"753","DOI":"10.7326\/M16-0961","article-title":"Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties","volume":"165","author":"Sinsky","year":"2016","journal-title":"Ann Intern Med"},{"issue":"01","key":"2021042419050184800_ocaa325-B29","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1055\/s-0037-1615747","article-title":"Time spent on dedicated patient care and documentation tasks before and after the introduction of a structured and standardized electronic health record","volume":"09","author":"Joukes","year":"2018","journal-title":"Appl Clin Inform"},{"issue":"5","key":"2021042419050184800_ocaa325-B30","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/S0002-9343(03)00057-3","article-title":"A cost-benefit analysis of electronic medical records in primary care","volume":"114","author":"Wang","year":"2003","journal-title":"Am J Med"},{"issue":"8","key":"2021042419050184800_ocaa325-B31","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.ijmedinf.2015.04.004","article-title":"The quality of paper-based versus electronic nursing care plan in Australian aged care homes: a documentation audit study","volume":"84","author":"Wang","year":"2015","journal-title":"Int J Med Inform"},{"issue":"8","key":"2021042419050184800_ocaa325-B32","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1111\/jonm.12423","article-title":"Working time use and division of labour among nurses and health-care workers in hospitals: a systematic review","volume":"24","author":"Lavander","year":"2016","journal-title":"J Nurs Manag"},{"key":"2021042419050184800_ocaa325-B33","author":"Schulte","year":"2019"},{"key":"2021042419050184800_ocaa325-B34","year":"2019"},{"key":"2021042419050184800_ocaa325-B35","year":"2017"},{"issue":"10057","key":"2021042419050184800_ocaa325-B36","doi-asserted-by":"crossref","first-page":"2272","DOI":"10.1016\/S0140-6736(16)31279-X","article-title":"Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis","volume":"388","author":"West","year":"2016","journal-title":"Lancet"},{"issue":"1","key":"2021042419050184800_ocaa325-B37","doi-asserted-by":"crossref","first-page":"215824401769715","DOI":"10.1177\/2158244017697154","article-title":"Burnout research: emergence and scientific investigation of a contested diagnosis","volume":"7","author":"Heinemann","year":"2017","journal-title":"SAGE Open"},{"issue":"1","key":"2021042419050184800_ocaa325-B38","doi-asserted-by":"crossref","DOI":"10.1186\/s12912-019-0382-7","article-title":"A cross-sectional study exploring the relationship between burnout, absenteeism, and job performance among American nurses","volume":"18","author":"Dyrbye","year":"2019","journal-title":"BMC Nurs"},{"issue":"7","key":"2021042419050184800_ocaa325-B39","doi-asserted-by":"publisher","DOI":"10.31478\/201707b","article-title":"Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care","volume":"7","author":"Dyrbye","year":"2017","journal-title":"NAM Perspectives"},{"issue":"7","key":"2021042419050184800_ocaa325-B40","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1097\/CCM.0000000000001885","article-title":"An official critical care societies collaborative statement\u2014burnout syndrome in critical care health-care professionals: a call for action","volume":"44","author":"Moss","year":"2016","journal-title":"Crit Care Med"},{"issue":"e1","key":"2021042419050184800_ocaa325-B41","doi-asserted-by":"crossref","first-page":"e100-6","DOI":"10.1136\/amiajnl-2013-001875","article-title":"Electronic medical records and physician stress in primary care: results from the MEMO Study","volume":"21","author":"Babbott","year":"2014","journal-title":"J Am Med Inform Assoc"},{"key":"2021042419050184800_ocaa325-B42","first-page":"1","article-title":"Electronic health record use a bitter pill for many physicians","volume":"13","author":"Meigs","year":"2016","journal-title":"Perspect Heal Inf Manag"},{"issue":"4","key":"2021042419050184800_ocaa325-B43","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1377\/hlthaff.2016.0811","article-title":"Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine","volume":"36","author":"Tai-Seale","year":"2017","journal-title":"Health Aff"},{"issue":"2","key":"2021042419050184800_ocaa325-B44","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1002\/job.4030020205","article-title":"The measurement of experienced burnout","volume":"2","author":"Maslach","year":"1981","journal-title":"J Organiz Behav"},{"issue":"2","key":"2021042419050184800_ocaa325-B45","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/smi.2849","article-title":"Cross-sectional survey of workplace stressors associated with physician burnout measured by the Mini-Z and the Maslach Burnout Inventory","volume":"35","author":"Olson","year":"2019","journal-title":"Stress Health"},{"issue":"4","key":"2021042419050184800_ocaa325-B46","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1093\/jamia\/ocz223","article-title":"Metrics for assessing physician activity using electronic health record log data","volume":"27","author":"Sinsky","year":"2020","journal-title":"J Am Med Inform Assoc"},{"issue":"4","key":"2021042419050184800_ocaa325-B47","first-page":"541","article-title":"Typed versus voice recognition for data entry in electronic health records: emergency physician time use and interruptions","volume":"15","author":"Dela Cruz","year":"2014","journal-title":"West J Emerg Med"},{"key":"2021042419050184800_ocaa325-B48","year":"2020"},{"issue":"7","key":"2021042419050184800_ocaa325-B49","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann Intern Med"},{"key":"2021042419050184800_ocaa325-B50","volume-title":"Covidence Systematic Review Software","year":"2018"},{"issue":"1","key":"2021042419050184800_ocaa325-B51","doi-asserted-by":"crossref","first-page":"160940691773384","DOI":"10.1177\/1609406917733847","article-title":"Thematic analysis: striving to meet the trustworthiness criteria","volume":"16","author":"Nowell","year":"2017","journal-title":"Int J Qual Methods"},{"issue":"4","key":"2021042419050184800_ocaa325-B52","first-page":"206","article-title":"Can scribes boost FPs\u2019 efficiency and job satisfaction?","volume":"66","author":"Earls","year":"2017","journal-title":"J Fam Pract"},{"issue":"5","key":"2021042419050184800_ocaa325-B53","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1370\/afm.2122","article-title":"Impact of scribes on physician satisfaction, patient satisfaction, and charting efficiency: a randomized controlled trial","volume":"15","author":"Gidwani","year":"2017","journal-title":"Ann Fam Med"},{"issue":"6","key":"2021042419050184800_ocaa325-B54","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.ophtha.2019.01.011","article-title":"Changes in electronic health record use time and documentation over the course of a decade","volume":"126","author":"Goldstein","year":"2019","journal-title":"Ophthalmology"},{"issue":"2","key":"2021042419050184800_ocaa325-B55","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1136\/jamia.2010.008441","article-title":"Use of electronic clinical documentation: time spent and team interactions","volume":"18","author":"Hripcsak","year":"2011","journal-title":"J Am Med Inform Assoc"},{"issue":"7","key":"2021042419050184800_ocaa325-B56","first-page":"e421","article-title":"Implementation to optimization: a tailored, data-driven approach to improve provider efficiency and confidence in use of the electronic medical record","volume":"14","author":"Kadish","year":"2018","journal-title":"J OncolPract"},{"issue":"1","key":"2021042419050184800_ocaa325-B57","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1055\/s-0037-1621705","article-title":"Efficiency of emergency physicians: insights from an observational study using EHR log files","volume":"9","author":"Kannampallil","year":"2018","journal-title":"Appl Clin Inform"},{"issue":"5","key":"2021042419050184800_ocaa325-B58","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/CIN.0000000000000516","article-title":"Changes in efficiency and quality of nursing electronic health record documentation after implementation of an admission patient history essential data set","volume":"37","author":"Karp","year":"2019","journal-title":"Comput Inform Nurs"},{"issue":"02","key":"2021042419050184800_ocaa325-B59","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1055\/s-0040-1705108","article-title":"Impact of patient census and admission mortality on pediatric intensive care unit attending electronic health record activity: a preliminary study","volume":"11","author":"Krawiec","year":"2020","journal-title":"Appl Clin Inform"},{"issue":"3","key":"2021042419050184800_ocaa325-B60","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1108\/IJHCQA-06-2018-0137","article-title":"Tracking resident pre-rounding electronic health record usage","volume":"32","author":"Krawiec","year":"2019","journal-title":"Int J Health Care Qual Assur"},{"issue":"6","key":"2021042419050184800_ocaa325-B61","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1136\/amiajnl-2012-000901","article-title":"Clinical documentation: composition or synthesis?","volume":"19","author":"Mamykina","year":"2012","journal-title":"J Am Med Inform Assoc"},{"issue":"6","key":"2021042419050184800_ocaa325-B62","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1097\/ACM.0000000000001148","article-title":"How do residents spend their shift time? A time and motion study with a particular focus on the use of computers","volume":"91","author":"Mamykina","year":"2016","journal-title":"Acad Med"},{"issue":"01","key":"2021042419050184800_ocaa325-B63","first-page":"011","article-title":"The impact of physician EHR usage on patient satisfaction","author":"Marmor","year":"2018","journal-title":"Appl Clin Inform"},{"issue":"01","key":"2021042419050184800_ocaa325-B64","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1055\/s-0039-3401815","article-title":"Physician burnout and timing of electronic health record use","volume":"04","author":"Micek","year":"2020","journal-title":"ACI Open"},{"issue":"3","key":"2021042419050184800_ocaa325-B65","doi-asserted-by":"crossref","first-page":"169","DOI":"10.7326\/M18-3684","article-title":"Physician time spent using the electronic health record during outpatient encounters a descriptive study","volume":"172","author":"Overhage","year":"2020","journal-title":"Ann Intern Med"},{"issue":"9","key":"2021042419050184800_ocaa325-B66","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1007\/s11606-019-05055-x","article-title":"Pajama time: working after work in the electronic health record","volume":"34","author":"Saag","year":"2019","journal-title":"J Gen Intern Med"},{"key":"2021042419050184800_ocaa325-B67","first-page":"537","author":"Smith"},{"issue":"6","key":"2021042419050184800_ocaa325-B68","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1002\/jhm.790","article-title":"Where did the day go? A time-motion study of hospitalists","volume":"5","author":"Tipping","year":"2010","journal-title":"J Hosp Med"},{"key":"2021042419050184800_ocaa325-B69","first-page":"136","article-title":"Burnout and EHR use among academic primary care physicians with varied clinical workloads","volume":"2019","author":"Tran","year":"2019","journal-title":"AMIA Jt Summits Transl Sci Proceedings AMIA Jt Summits Transl Sci"},{"issue":"4","key":"2021042419050184800_ocaa325-B70","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1136\/jamia.2010.004440","article-title":"Quantifying the impact of health IT implementations on clinical workflow: a new methodological perspective","volume":"17","author":"Zheng","year":"2010","journal-title":"J Am Med Inf Assoc"},{"issue":"2","key":"2021042419050184800_ocaa325-B71","doi-asserted-by":"crossref","first-page":"135","DOI":"10.22454\/FamMed.2020.942762","article-title":"EHR overtime: an analysis of time spent after hours by family physicians","volume":"52","author":"Anderson","year":"2020","journal-title":"Fam Med"},{"issue":"2","key":"2021042419050184800_ocaa325-B72","doi-asserted-by":"crossref","first-page":"e0205379","DOI":"10.1371\/journal.pone.0205379","article-title":"Characterizing electronic health record usage patterns of inpatient medicine residents using event log data","volume":"14","author":"Wang","year":"2019","journal-title":"PLoS One"},{"issue":"4","key":"2021042419050184800_ocaa325-B73","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1093\/jamia\/ocz220","article-title":"Electronic health records and burnout: time spent on the electronic health record after hours and message volume associated with exhaustion but not with cynicism among primary care clinicians","volume":"27","author":"Adler-Milstein","year":"2020","journal-title":"J Am Med Informatics Assoc"},{"issue":"5","key":"2021042419050184800_ocaa325-B74","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1016\/j.jvs.2018.08.173","article-title":"Vascular surgery residents spend one fifth of their time on electronic health records after duty hours","volume":"69","author":"Aziz","year":"2019","journal-title":"J Vasc Surg"},{"issue":"12","key":"2021042419050184800_ocaa325-B75","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1097\/ACM.0000000000000792","article-title":"Improving documentation timeliness: a \u201cbrighter future\u201d for the electronic medical record in resident clinics","volume":"90","author":"Carlson","year":"2015","journal-title":"Acad Med"},{"key":"2021042419050184800_ocaa325-B76","first-page":"348","article-title":"Quantifying and visualizing nursing flowsheet documentation burden in acute and critical care","volume":"2018","author":"Collins","year":"2018","journal-title":"AMIA. Annu Symp Proc AMIA Symp"},{"issue":"4","key":"2021042419050184800_ocaa325-B77","doi-asserted-by":"crossref","first-page":"270","DOI":"10.4258\/hir.2016.22.4.270","article-title":"Factors associated with the timeliness of electronic nursing documentation","volume":"22","author":"Ahn","year":"2016","journal-title":"Healthc Inform Res"},{"issue":"6","key":"2021042419050184800_ocaa325-B78","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1097\/NUR.0000000000000250","article-title":"Improving effectiveness and satisfaction of an electronic charting system in Taiwan","volume":"30","author":"Hsieh","year":"2016","journal-title":"Clin Nurse Spec"},{"issue":"26","key":"2021042419050184800_ocaa325-B79","article-title":"Impact of a new medical record system for emergency departments designed to accelerate clinical documentation: a crossover study","volume":"94","author":"Inokuchi","year":"2015","journal-title":"Med (United States)"},{"issue":"6","key":"2021042419050184800_ocaa325-B80","first-page":"531","article-title":"Characterizing electronic health record usage patterns of inpatient medicine residents using event log data","volume":"9","author":"Zheng","year":"2018","journal-title":"PLoS One"},{"key":"2021042419050184800_ocaa325-B81","first-page":"783","article-title":"Changes in electronic health record use time over a decade of use","author":"Goldstein","year":"2019","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"2021042419050184800_ocaa325-B82","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.jbi.2014.02.017","article-title":"Time motion studies in healthcare: what are we talking about?","volume":"49","author":"Lopetegui","year":"2014","journal-title":"J Biomed Inform"},{"issue":"01","key":"2021042419050184800_ocaa325-B83","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1055\/s-0038-1676819","article-title":"Automatic detection of front-line clinician hospital shifts: a novel use of electronic health record timestamp data","volume":"10","author":"Dziorny","year":"2019","journal-title":"Appl Clin Inform"},{"issue":"1","key":"2021042419050184800_ocaa325-B84","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1258\/135581907779497576","article-title":"A comparison of self-reported and observational work sampling techniques for measuring time in nursing tasks","volume":"12","author":"Ampt","year":"2007","journal-title":"J Health Serv Res Policy"},{"issue":"3","key":"2021042419050184800_ocaa325-B85","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1097\/00005110-200003000-00003","article-title":"A comparison of time-and-motion and self-reporting methods of work measurement","volume":"30","author":"Burke","year":"2000","journal-title":"J Nurs Adm"},{"issue":"5","key":"2021042419050184800_ocaa325-B86","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1136\/amiajnl-2011-000083","article-title":"Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research","volume":"18","author":"Zheng","year":"2011","journal-title":"J Am Med Inform Assoc"},{"issue":"3","key":"2021042419050184800_ocaa325-B87","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1093\/jamia\/ocz196","article-title":"Using electronic health record audit logs to study clinical activity: a systematic review of aims, measures, and methods","volume":"27","author":"Rule","year":"2020","journal-title":"J Am Med Inform Assoc"},{"issue":"1","key":"2021042419050184800_ocaa325-B88","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.juro.2010.03.040","article-title":"Scribes in an ambulatory urology practice: patient and physician satisfaction","volume":"184","author":"Koshy","year":"2010","journal-title":"J Urol"},{"issue":"3","key":"2021042419050184800_ocaa325-B89","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.ijmedinf.2011.12.001","article-title":"The effects of EMR deployment on doctors\u2019 work practices: a qualitative study in the emergency department of a teaching hospital","volume":"81","author":"Park","year":"2012","journal-title":"Int J Med Inform"},{"issue":"1","key":"2021042419050184800_ocaa325-B90","doi-asserted-by":"crossref","first-page":"7","DOI":"10.13063\/2327-9214.1176","article-title":"User-composable electronic health record improves efficiency of clinician data viewing for patient case appraisal: a mixed-methods study","volume":"4","author":"Senathirajah","year":"2016","journal-title":"eGEMs"},{"key":"2021042419050184800_ocaa325-B91","first-page":"Doc09","article-title":"Differential diagnostic of the burnout syndrome","volume":"6","author":"Korczak","year":"2010","journal-title":"GMS Health Technol Assess"},{"issue":"7","key":"2021042419050184800_ocaa325-B92","doi-asserted-by":"crossref","first-page":"e0159015","DOI":"10.1371\/journal.pone.0159015","article-title":"Healthcare staff wellbeing, burnout, and patient safety: a systematic review","volume":"11","author":"Hall","year":"2016","journal-title":"PLoS One"},{"key":"2021042419050184800_ocaa325-B93","first-page":"1","author":"Wickramage"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/28\/5\/998\/37335280\/ocaa325.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/28\/5\/998\/37335280\/ocaa325.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T19:09:27Z","timestamp":1619291367000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/28\/5\/998\/6090156"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,12]]},"references-count":93,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,1,12]]},"published-print":{"date-parts":[[2021,4,23]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocaa325","relation":{},"ISSN":["1527-974X"],"issn-type":[{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,5,1]]},"published":{"date-parts":[[2021,1,12]]}}}