{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T10:47:14Z","timestamp":1777027634121,"version":"3.51.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T00:00:00Z","timestamp":1667347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["T32-HS026116-04"],"award-info":[{"award-number":["T32-HS026116-04"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Pennsylvania, Perelman School of Medicine"},{"name":"National Institutes of Health\u2019s National Center for Advancing Translational Sciences","award":["KL2TR002492"],"award-info":[{"award-number":["KL2TR002492"]}]},{"name":"National Institutes of Health\u2019s National Center for Advancing Translational Sciences","award":["UL1TR002494"],"award-info":[{"award-number":["UL1TR002494"]}]},{"DOI":"10.13039\/100007249","name":"University of Minnesota","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007249","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We analyze observed reductions in physician note length and documentation time, 2 contributors to electronic health record (EHR) burden and burnout.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We used EHR metadata from January to May, 2021 for 130\u00a0079 ambulatory physician Epic users. We identified cohorts of physicians who decreased note length and\/or documentation time and analyzed changes in their note composition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>37\u00a0857 physicians decreased either note length (n\u2009=\u200915\u00a0647), time in notes (n\u2009=\u200915\u00a0417), or both (n\u2009=\u20096793). Note length decreases were primarily attributable to reductions in copy\/paste text (average relative change of \u201318.9%) and templated text (\u201317.2%). Note time decreases were primarily attributable to reductions in manual text (\u201327.3%) and increases in note content from other care team members (+21.1%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Organizations must consider priorities and tradeoffs in the distinct approaches needed to address different contributors to EHR burden.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Future research should explore scalable burden-reduction initiatives responsive to both note bloat and documentation time.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocac211","type":"journal-article","created":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T23:27:59Z","timestamp":1667431679000},"page":"355-360","source":"Crossref","is-referenced-by-count":11,"title":["I had not time to make it shorter: an exploratory analysis of how physicians reduce note length and time in notes"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7775-8544","authenticated-orcid":false,"given":"Nate C","family":"Apathy","sequence":"first","affiliation":[{"name":"National Center for Human Factors in Healthcare, MedStar Health Research Institute , Washington, District of Columbia, USA"},{"name":"Center for Biomedical Informatics, Regenstrief Institute , Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison J","family":"Hare","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital , Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Fendrich","sequence":"additional","affiliation":[{"name":"Emmett Interdisciplinary Program in Environment & Resources, Doerr School of Sustainability, Stanford University , Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dori A","family":"Cross","sequence":"additional","affiliation":[{"name":"Division of Health Policy & Management, School of Public Health, University of Minnesota , Minneapolis, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,11,2]]},"reference":[{"issue":"1","key":"2023011811023984700_ocac211-B1","doi-asserted-by":"crossref","first-page":"50","DOI":"10.7326\/M18-0139","article-title":"Physician burnout in the electronic health record era: are we ignoring the real cause?","volume":"169","author":"Downing","year":"2018","journal-title":"Ann Intern Med"},{"issue":"10","key":"2023011811023984700_ocac211-B2","doi-asserted-by":"crossref","first-page":"e2128790","DOI":"10.1001\/jamanetworkopen.2021.28790","article-title":"Analysis of electronic health record use and clinical productivity and their association with physician 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