Electronic documentation increases length of stay in ED

The implementation of electronic health records (EHRs) are meant to streamline healthcare organizations with quicker, more efficient documentation. But according to a study published in in Annals of Emergency Medicine, electronic documentation adversely affects the efficiency of emergency departments (ED).

With the move from paper to EHRs, the documentation process was meant to take less time out of a physician’s workload while increasing efficiency and reducing record errors. This study analyzed how a custom electronic documentation (eDoc) system affected operation performance to outline barriers and improvements to current organizations.

The study included data from one year before and a year after the implementation of eDoc in a single ED. A total of 60,870 pre- and 59,337 post-implementation patient encounters were measured for mean length of stay. Results showed the implementation of eDoc systems had increased the overall length of stay for patients by 8.4 minutes, as well as the length of stay for discharged patients by 1.8 minutes.

“In our single-center study, the isolated implementation of eDoc was associated with increases in overall and discharge length of stay,” concluded first author Joshua Feblowitz, MD, MS, and colleagues. “Our findings suggest that a custom-designed electronic provider documentation may negatively affect ED throughput. Strategies to mitigate these effects, such as reducing documentation requirements or adding clinical staff, scribes, or voice recognition, would be a valuable area of future research.”