Gender and Academic Rank Disparities in Electronic Health Record Burden Among Otolaryngologists

Objectives: The electronic health record (EHR) has benefits but also adds documentation burden that is not equally shared between academic faculty. We hypothesize that male gender and senior academic rank are associated with decreased EHR burden compared to female and junior faculty. Methods: Demographics from faculty at participating organizations were combined with 3 years of provider efficiency data. Multivariate analyses were performed to evaluate the differences in EHR burden between genders and academic ranks, clustering for otolaryngologist and institution. Results: Forty-six institutions with 914 otolaryngologists (female, n = 283, 31%) were included for analysis. Median hours per day (h/d) spent in EHR tasks related to outpatient visits were 4.3, 3.5, and 3.4 h/d for female assistant, associate, and full professors, respectively; and 3.4, 2.7, and 2.3 h/d for males, likewise in ascending academic rank. These differences between median h/d in ambulatory time were significant across all six subgroups of gender and academic rank (p < 0.002). Academic seniority, but not gender, was associated with less time in ambulatory tasks after work and on days without scheduled appointments (p < 0.002). Males and otolaryngologists with higher academic rank were more likely to receive help with notes and orders (p < 0.002). Conclusions: For a typical clinic day, female assistant professors in academic otolaryngology spent nearly twice as much time as their male full professor counterparts did in the EHR completing tasks related to ambulatory patient care. The differential likelihood of faculty receiving help with notes and orders may play a role in this disparity. Level of Evidence: 3.