Does autotext usage decrease documentation time among resident physicians? A retrospective analysis of electronic health record usage data.

Objective: Usage of autotext or "dotphrases" is ubiquitous among provider workflows in electronic health records (EHRs). Yet, little is known about the impact of these tools in inpatient settings and among resident physicians. We aimed to evaluate the association between autotext usage and documentation time among resident physicians in an academic medical center using the Cerner EHR.

Materials and methods: The association between autotext executions and documentation time per patient seen for 705 resident physicians rotating at a large academic medical center from July 2021 to June 2023 was analyzed via linear regression after controlling for specialty, post-graduate year (PGY), provider gender and patient volume.

Results: There was no significant overall association between autotext executions per patient seen and documentation time per patient seen in specialties using Dynamic Documentation as their primary workflow (β=-0.1 min per autotext execution per patient seen, 95% CI -0.6 to 0.5 min, P =.79). However, there was increased documentation time among residents with no autotext usage compared to residents who used autotext, and this effect was mediated by use of personalized autotexts. Specialty, PGY, gender and patient volume were significant determinants of documentation time.

Discussion: Efforts to decrease documentation time among resident physicians should encourage autotext adoption but should not be focused on promotion of autotext usage alone. Further research should address the questions of identifying other determinants of documentation time, autotext design standards, and how autotext usage affects measures of note quality.

Conclusion: Autotext adoption decreases documentation time among resident physicians, but among those who adopt autotext, higher levels of usage show no benefit.