The Keystroke Tax in Digital Healthcare: Giving Doctors Their Voice in Uzbekistan's Medical Transformation

The digitalisation of healthcare promises greater efficiency, yet electronic health records (EHRs) may unintentionally increase physicians' administrative workload. This paper introduces the concept of the keystroke tax: the time, effort and organisational resources consumed by manual clinical documentation. Drawing on a quasi-experimental investigation involving 120 physicians in Uzbekistan, the study examines automatic speech recognition (ASR) as an alternative to keyboard-based medical record creation. The findings indicate a 41% reduction in documentation time per 100 words, a 30.4% increase in recorded text volume and improved physician satisfaction. Nevertheless, persistent copy-and-paste practices reveal that technological convenience alone cannot transform established clinical behaviour. A hybrid, physician-supervised documentation framework is consequently proposed to connect digital innovation with sustainable healthcare management.