Time Burden of Electronic Medical Records on Nurses and Physicians in Saudi Arabia: Occurrence, Predictors, and Challenges. A Mixed Method Study

Background: In healthcare, Electronic Medical Records (EMRs) offer centralized access to patient data and enable evidence-based clinical decision-making. and operational efficiency. However, they have introduced administrative burdens for the clinicians, potentially impacting job satisfaction and care quality. Despite the widespread EMR adoption in Saudi Arabia, the issue of time burden related to EMRs and the factors re-lated to it are underexplored. Objectives: To measure the average number of hours (per month and as percentage out of total monthly working hours) of EMR use among physicians and nurses, compare the mean monthly hours of EMR use between them, and identify the demographic predictors of extended hours of EMR use. Moreover, it aims to understand the perceived challenges and barriers of timely filling EMRs, and the impact of EMRs on quality of patient care. Methods: A sequential mixed-methods study was conducted at three Security Forces Hospitals in Riyadh, Dammam, and Makkah. Quantitively, a correlational cross-sectional design was used was employed with multistage stratified sampling using a validated 30-item questionnaire, and data were analyzed using differential and inferential statistics. The qualitative phase in-volved purposive sampling of ten clinicians and semi-structured interviews analyzed through thematic analysis. Results: A total of 503 professionals (162 physicians, 341 nurses) participated. Majority were females (67.2%), aged 30 to 40 years (44.9%), and non-Saudi (62%). Nurses reported significantly higher mean of EMR usage hours/day than physicians (5.43 versus 4.34 hours/day, p=0.001). Significant predictors of ex-tended EMR use include age 30-50 years, female gender, non-Saudi nationality, higher education, nursing profession, longer healthcare experience, 5-10 years EMR experi-ence, 10+ hours EMR training, and participants from Makkah. Qualitative analysis identified barriers such as infrastructure constraints, system performance and tech-nical issues, lack of IT support, and workflow and professional burden. Regarding EMR impact, they improved professional practice and patient safety, however, concerns were raised regarding adjustments in work routine Conclusion: EMR use carries con-siderable administrative burden, especially nurses when compared to physicians. Ad-dressing the identified barriers through targeted training, better system design, and improved workflows could boost efficiency and support high-quality patient care. The findings offer evidence-based insights to guide policy and system-level improvements.