I had not time to make it shorter: an exploratory analysis of how physicians reduce note length and time in notes

J Am Med Inform Assoc. 2023 Jan 18;30(2):355-360. doi: 10.1093/jamia/ocac211.


Objective: We analyze observed reductions in physician note length and documentation time, 2 contributors to electronic health record (EHR) burden and burnout.

Materials and methods: We used EHR metadata from January to May, 2021 for 130 079 ambulatory physician Epic users. We identified cohorts of physicians who decreased note length and/or documentation time and analyzed changes in their note composition.

Results: 37 857 physicians decreased either note length (n = 15 647), time in notes (n = 15 417), or both (n = 6793). Note length decreases were primarily attributable to reductions in copy/paste text (average relative change of -18.9%) and templated text (-17.2%). Note time decreases were primarily attributable to reductions in manual text (-27.3%) and increases in note content from other care team members (+21.1%).

Discussion: Organizations must consider priorities and tradeoffs in the distinct approaches needed to address different contributors to EHR burden.

Conclusion: Future research should explore scalable burden-reduction initiatives responsive to both note bloat and documentation time.

Keywords: documentation; electronic health records; health policy; physician burnout.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Burnout, Professional* / prevention & control
  • Documentation
  • Electronic Health Records
  • Humans
  • Physicians*
  • Software