Don’t say you weren’t warned: A new study seems to suggest that physicians spend an ever-growing amount of time with their electronic health record technology. That said, if your back is turned against your patients during a visit, you may want to consider a new arrangement so you're not forced to turn your back on a patient.
Even though EHR vendors and others who lobbied for the widespread use of the technology in practice, spurred on by the somewhat disjointed federal Meaningful Use efforts to provide users with cash for the technology, doctors are reportedly splitting their time between face-to-face visits with patients and time on the computer.
The study of 471 primary care physicians, published in Health Affairs, suggests that physicians spent on average just more than three hours on office visits and nearly the same (but slightly more time on what was called “desktop medicine,” including typing progress notes in an electronic health record, each day.
According to the report and Fierce Healthcare, other desktop medicine activities included “communicating with patients via a secure patient portal, logging telephone encounters, exchanging secure messages with patients and refilling prescriptions. Doctors also spent time on the computer ordering tests, sending staff messages and reviewing test results.”
The study used data captured by the access time stamp function on the EHR in more than 31 million transactions from 2011 to 2014. The doctors “collectively worked on 765,129 patients’ records. Over time, doctors spent less time in face-to-face visits and more time on the computer, the study found,” Fierce adds.
Given the shift in how doctors spend their time, staffing and scheduling in the physician’s office, as well as provider payment models for primary care practice, should account for these desktop medicine activities, the study authors said.
This is not the only study of its kind, of course. In 2016, another study confirms the data above -- practicing physicians have claimed correctly, published in the Annals of Internal Medicine, that during office hours physicians spent nearly 50 percent of their time on EHR tasks and desk work.
That research concluded that for every hour physicians provide direct clinical face time to patients, nearly two additional hours are spent on EHR and desk work within the clinic day, double that of the Health Affairs survey. Additionally, outside office hours, physicians supposedly spend another one to two hours of personal time each night doing additional computer and other clerical work.
This particular study was funded by American Medical Association. The feedback in the 2016 study was collected from observations of 57 physicians working in ambulatory care in four specialties—family medicine, internal medicine, cardiology and orthopedics, in Illinois, New Hampshire, Virginia and Washington.
Specifically, physicians spent 27 percent of their total time on direct clinical face time with patients and nearly 50 percent of their time on EHR and desk work. According to reporting by Healthcare Informatics, while in the examination room with patients, physicians spent 53 percent of the time on direct clinical face time and 37 percent on EHR and desk work. “In addition, about one-third of the physicians also completed after-hours diaries and they reported one to two hours of after-hours work each night, devoted mostly to EHR tasks.”
In their current state, EHRs occupy a lot of physicians' time and draw attention away from their direct interactions with patients and from their personal lives. Also according to the news site, “Many studies have documented lower patient satisfaction when physicians spend more time looking at the computer and performing clerical tasks. Patient satisfaction can affect health outcomes via adherence to the care plan and can also affect physician and hospital reimbursement, so the stakes are high.”
As the technology continues to permeate, then, we’re likely to see physicians continue to struggle or with their trying to manage the technology that is between them and their patients, and which takes away time from their personal lives, as the studies here suggest.