For every hour that physicians spend with patients, they spend nearly an additional two hours on electronic health record (EHR) tasks and desk work each clinic day, according to a new study published, fittingly, on Labor Day.
The study is sure to add to the debate over how much EHR tasks are contributing to physician burnout.
Many reporters have tackled the subject of physician burnout in their own communities, and physician leaders have called for more clinician support in computer and administrative tasks.
This new study, published in the Annals of Internal Medicine, focused only on physicians working in ambulatory care practices. The researchers spent 430 hours observing 57 physicians practicing in four states (Illinois, New Hampshire, Virginia and Washington state). The physician practices were in family medicine, internal medicine, cardiology and orthopedics.
While during the examination room, the physicians spent about half their time (52.9 percent) on direct patient face time, and 37 percent of time on EHR and desk work. In the overall office day, they spent about half their time doing EHR or desk work, and 27 percent of total time on direct clinical time with patients.
Additionally, 21 physicians completed after-hours diaries and reported another one to two hours of work each night, mostly doing EHR tasks. The study was funded by the American Medical Association.
So what EHR tasks were taking up so much physician time? Recording details about the patient encounter took up the most time (38.5 percent of total time). Other EHR-focused activities included accessing test results, ordering medications and vaccinations and providing referrals. Administrative tasks included health insurance and claims paperwork and scheduling patients.
The researchers noted that two physician practices agreed to participate in the study but then withdrew, saying they “couldn’t cope“ with anything extra.
In an accompanying editorial, Dr. Susan Hingle of the SIU School of Medicine in Springfield, Ill., wrote that study confirmed anecdotal reports that “EHRs, in their current state, occupy a lot of physicians’ time and draw attention away from their direct interactions with patients and from their personal lives.”
For reporters, how can we advance the story beyond physician burnout? The study and editorial offer some resources. Are physician practices in your area engaged in any of these attempts to improve the physician workday? What has been the response or success in reducing physician computer burdens?
- Training strategies for time management: The AMA has a program called STEPS Forward that uses online modules and live events to teach strategies for time management and achieving better patient management.
- Tips on reducing administrative work: The American College of Physicians has a “Patients Before Paperwork“ initiative to reduce administrative burdens.
- EHR design changes to be more clinician-friendly: The ACP also has a position paper “Clinical Documentation in the 21st Century“ that offers recommendations on EHR design and clinical documentation.
- Clerical support: Documentation support with either dictation or documentation assistance can increase clinician face time with patients, the authors of the study wrote.
As journalists, we can explore to what degree physicians are being overburdened by computer work and whether strategies to reduce those burdens are helping.