Physicians spend 16 minutes and 14 seconds in the electronic health record (EHR) for each outpatient visit, according to a 2020 study in the Annals of Internal Medicine that covered about 100 million encounters. Primary care physicians spend more, at 19 minutes and 48 seconds per visit.
For a practice manager, that number sets the real length of a visit. The scheduled slot covers the exam room. The EHR time runs well past it, and a share of it lands at night.
What the largest EHR time study measured
The study by Overhage and McCallie used activity data from Cerner's Lights On Network. It covered about 155,000 physicians and about 100 million ambulatory encounters in nonsurgical specialties. Healio reported the results on January 13, 2020. Both authors disclosed financial ties to Cerner, and the data came from one EHR vendor's user base.
The average active EHR time was 16 minutes and 14 seconds per encounter. Of that time, 11% fell after hours, which the study defined as 6 p.m. to 6 a.m. on weekdays and any time on weekends. The study counted work done in a one-month window after the visit, so charting finished days later is included.
Where the 16 minutes go
Three tasks account for most of the time. Chart review is the largest at 33% of EHR time, or 5 minutes and 22 seconds per visit. Documentation takes 24%, or 3 minutes and 51 seconds. Ordering takes 17%, or 2 minutes and 42 seconds.
| Task | Share of EHR time | Time per encounter | Source |
|---|---|---|---|
| Chart review | 33% | 5 min 22 sec | Healio, 2020, on Annals of Internal Medicine study |
| Documentation | 24% | 3 min 51 sec | Healio, 2020, on Annals of Internal Medicine study |
| Ordering | 17% | 2 min 42 sec | Healio, 2020, on Annals of Internal Medicine study |
| All other EHR functions | 26% (remainder after the three above) | Not reported | Calculated from the shares above |
Chart review takes 1 minute and 31 seconds more per visit than documentation does. A practice that tunes only the note template leaves the largest block of time alone.
Primary care spends more time than the average
Primary care physicians averaged 19 minutes and 48 seconds of active EHR time per encounter, according to the same study. That is 3 minutes and 34 seconds above the all-specialty average of 16 minutes and 14 seconds. Internal medicine averaged 18 minutes and 19 seconds. Family medicine averaged 15 minutes and 52 seconds.
The gap between internal medicine and family medicine is 2 minutes and 27 seconds per visit. Two practices of equal size can carry different EHR loads if their visit mix differs. Healio's summary does not give a separate figure for physicians outside primary care.
What separates physicians who finish charts the same day
A study in JAMIA Open (volume 9, issue 1, January 2026), listed by the Yale School of Medicine, examined de-identified monthly EHR data from over 218,000 physicians at 413 U.S. healthcare organizations. The data ran from May 2019 to April 2022.
Physicians who answered inbox messages within 1.5 days and kept after-hours documentation under 25 minutes per day were more likely to complete charts the same day. For higher daily visit volumes, two thresholds stood out. Those physicians spent less than 4.1 minutes on EHR tasks outside scheduled hours, and less than 3.2 minutes reviewing patient records per visit.
The Yale page does not report effect sizes or confidence intervals. The thresholds went with high output in this data. The page does not show that they cause it.
How often practices work around the system
MGMA ran a Stat poll on July 21, 2026, with 216 applicable responses, and published the results on July 23, 2026. It asked how often clinicians use workarounds for EHR or practice management system problems. In the results, 43% of groups said frequently, 32% said sometimes, 16% said rarely, 3% said never, and 6% were unsure. Frequent and occasional use together reach 75%.
MGMA also cited a 2025 poll in which 30% of group leaders named EHR usability as their top technology priority. AI tools ranked first at 32%. The two priorities sit 2 points apart.
Respondents described one common pattern: a shared spreadsheet that tracks authorizations, scheduling, and results because the EHR has no work queue for those steps. Every minute spent in such a sheet is EHR-adjacent time that the Annals figures do not count.
Turn the study averages into a schedule check
The arithmetic below uses the Annals averages. It is a calculation, not a measurement of your practice. A physician who sees 20 patients in a day at 16 minutes and 14 seconds each logs about 325 minutes in the EHR, or 5.4 hours. At the study's 11% after-hours share, about 36 of those minutes fall outside the workday.
Your own audit logs will give better numbers. Most EHRs report active time by user and by task. Pull one month of data for each physician and split it into the same four buckets: chart review, documentation, ordering, and everything else. Compare each physician to the 16-minute average and to the 25-minute daily after-hours marker from the JAMIA Open study.
Primary care groups can compare against 19 minutes and 48 seconds instead.
Sources
- Healio, Physicians spend 16 minutes using EHR for each patient encounter, January 13, 2020
- Yale School of Medicine, EHR Use Patterns Linked to Physician Efficiency and Productivity (JAMIA Open, January 2026)
- MGMA Stat, EHR and PM workarounds reveal the hidden cost of broken workflows, July 23, 2026
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