Differences in Electronic Medical Record Time Usage Depending on Neurology Trainee Gender
Billie Hsieh1, Thy Nguyen1
1Neurology, University of Texas Health Science Center
Objective:
We aimed to determine whether gender affects electronic medical record (EMR) usage in neurology trainees. 
Background:
 A review of the literature indicates that female physicians spend more time accessing EMR than do male physicians across specialties. Additionally, studies have identified EMR usage as tied to physician burnout. Female physicians are considered at higher risk of burnout.   
Design/Methods:
A cross-sectional study was performed, analyzing the number of and time spent on in-basket messages during 1 month of neurology residency continuity clinic. Variables examined include gender, PGY level, average patient count per clinic, documentation time, time spent answering in-basket messages, number of staff messages, and number of patient messages. In this study, based on participant preference, gender was defined as sex assigned at birth. 
Results:
Twetny-one physicians-in-training were surveyed using the Epic signal efficiency report system. There was a 42 percent increase in the total hours spent on in-basket (female 2.3, male 1.6, p 0.35), 165 percent increase in number of in-basket staff messages (female 2.3, male 0.8, p 0.21), 40 percent increase in documentation hours (female 8.5, male 6.1, p 0.11), and 113 percent increase in results received per day (female 4.4, male 2, p 0.25). There was a 5 percent decrease in appointment hours (female 3.7, male 3.9, p 0.65), 5 percent decrease in hours spent on orders (average female 5.4, male 5.7, p 0.83), and 16 percent decrease in hours spent on patient calls (female 0.2, male 0.3, p 0.83). 
Conclusions:
 Female trainees spend substantially more time than their male colleagues answering in-basket messages and documentation. These data concur with previous reports of increased communication requests with female physicians compared to males. Increased time spent on requests may contribute to higher burnout rates in female physicians. This study reveals that differences in EMR usage by gender were identified early in neurology training. 
10.1212/WNL.0000000000202936