• Katherine L Liang, Ellen J Gelles, and Yasir Tarabichi.
• Center for Clinical Informatics Research and Education, MetroHealth, Cleveland, OH.
• Fam Med. 2025 Jan 1; 57 (1): 283428-34.

Background And ObjectivesElectronic health record (EHR) customization is proposed to mitigate EHR-related burnout. Gender disparities in EHR usage are established, though less is known regarding differences in customization and its impact on EHR time. This study examined gender differences in vendor-derived proficiency score (PS) and its relationship to EHR time.MethodsThis was a retrospective observational study of ambulatory EHR use for adult primary care and medical subspecialty physicians at an academic safety-net health care system. The EHR vendor provided a physician PS (0-10), derived from customization and efficiency tool utilization. Primary outcomes were PS, time in system per day, and time in system per appointment stratified by gender. We used multiple variable linear regression to determine whether gender differences persisted with the inclusion of other factors.ResultsA total of 228 physicians were included in the study; 122 were women, and 106 were men. Women had higher median PS (7.6 vs 6.6, P=.021) and EHR time per day (150.5 vs 119.9 minutes, P=.013), but no difference in time per appointment (24.7 vs 26.1 minutes, P=.665). After adjusting for potential confounders, gender remained a significant predictor of PS, but not time in EHR. Higher PS was significantly associated with greater time in the system per appointment, but not per day.ConclusionsWhile women had higher PS than men, gender was not significantly associated with measures of EHR time after adjusting for potential confounders. Higher PS was associated with greater time in the EHR per appointment, suggesting factors that influence EHR time are complex and varied.

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