For Physicians, Where Does the Time Go?
A study of 57 U.S. physicians in four different states found that for every hour of direct clinical face time with patients, there was nearly two additional hours spent on electronic health records (EHR) and other clerical work. Furthermore, the physicians reported spending up to an additional 1 to 2 hours of after-hours personal time completing documentation and EHR tasks.
Researchers measured time spent on direct clinical time, on electronic health record (HER) and desk work, on administrative tasks, and other tasks. They're results showed that physicians spent 33.1% of their total work activities during office hours on direct clinical face time (27% with patients in the examination room and 6.1% with staff when the patient was not present).
EHR and desk work took a total of 49.2% of the physicians' total time, with 38.5% of this time spent on documentation and review tasks, and the remaining 6.4% spent on test results, 2.4% on medication orders, and 2% on other orders. The remaining time included breaks, transit time, and time closed to observation.
During examination room time with patients, the physicians spent 52.9% of their time on direct clinical face time, 37.0% on EHR and desk work, and 10.1% on administrative and other tasks.
Of the 57 physicians in the study, 21 had dictation support and five had a documentation assistant. Physicians with these supports spent more time on direct clinical face time with patients than those without; 43.9% vs. 31.4%, respectively.
A separate recent study found that physicians who use EHRs and computerized physician order entry had decreased satisfaction and a higher risk for burnout (Shanafelt TD, Dyrbye LN, Sinsky C, Hasan O, Satele D, Sloan J, et al. Mayo Clinical Proceedings. 2016; 91:836-48).
The authors of the time and motion study acknowledged that their small sample size of 57 limited the findings and inhibited comparisons across specialties. They concluded by calling for further study to, “identify links between variations in use of physician resources and clinical, financial, and professional satisfaction outcomes.”
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