Journal of General Internal Medicine

, Volume 34, Issue 7, pp 1096–1097 | Cite as

The Thrill Is Gone: Burdensome Electronic Documentation Takes Its Toll on Physicians’ Time and Attention

  • Mindy E. FlanaganEmail author
  • Laura G. Militello
  • Nicholas A. Rattray
  • Ann H. Cottingham
  • Richard M. Frankel
Concise Research Reports


Exam room computing has become ubiquitous in outpatient clinic visits as electronic health record (EHR) documentation requirements for “meaningful use” are adopted. Despite its initial promise, EHRs have created several unanticipated consequences, not the least of which is that physicians’ attention during patient visits being split between delivering care and completing EHR documentation tasks. Even with real-time documentation in the exam room, the majority of physicians spend additional time after hours completing EHR-related tasks.1 In a recent survey, physicians who reported inadequate time for documentation and “excessive” use of the EHR at home had higher rates of burnout.2


We recruited a convenience sample of five Veterans Affairs physicians (four primary care physicians and one specialist) who agreed to participate in Cognitive Task Analysis (CTA) interviews. The interviews consisted of a task diagram, followed by a series of cognitive probes aimed at...


electronic medical record ambulatory care physician-patient relations attitude to computers 


Author Contributions

Zamal Franks conducted two of the interviews but does not meet criteria for authorship.


VA HRSD funded this work.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.


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Copyright information

© Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2019

Authors and Affiliations

  • Mindy E. Flanagan
    • 1
    Email author
  • Laura G. Militello
    • 2
  • Nicholas A. Rattray
    • 1
    • 3
  • Ann H. Cottingham
    • 4
  • Richard M. Frankel
    • 1
    • 4
  1. 1.VA HSR&D Center for Health Information and CommunicationRoudebush VAMCIndianapolisUSA
  2. 2.Applied Decision Science, LLCCincinnatiUSA
  3. 3.Department of AnthropologyIndiana University-Purdue University IndianapolisIndianapolisUSA
  4. 4.Indiana University School of MedicineIndianapolisUSA

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