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Physicians Spend Much More Time With EHRs Than Patients

CHICAGO – If you feel as if you spend more than twice as much time staring at a computer screen as you spend actually engaging with patients, your instincts probably are right on target.

A study published recently in Annals of Internal Medicine finds that, for every hour physicians provide direct clinical face time to patients, nearly two additional hours are spent on electronic health records (EHR) and other clerical work within the clinic day.

The computer time doesn’t end there, however, according to the American Medical Association-led research: Physicians spend another hour or two each night doing additional clerical work outside of the office.

No surprise, then, that the time-and-motion study researchers suggest the burden of EHRs is contributing to physician burnout.

For the report, the study team observed 57 U.S. physicians in four states — Illinois, New Hampshire, Virginia, and Washington — to describe how their time was allocated in ambulatory practice. In addition, the participating physicians completed diaries about their after-hours work.

Results indicate that, during the office day, physicians spent 27% of their total time on direct clinical face time with patients, but more than 49% on EHRs and desk work. The computer screen even demanded physician attention in the exam room, where 53% of their time was focused on the patient but another 37% on EHRs and desk work. The additional one to two hours each night of clerical work also tended to be related to EHRs, according to the researchers.

Study authors suggest documentation support with either dictation or documentation assistant services could increase direct clinical face time with patients.

The study confirms “what many practicing physicians have claimed: Electronic health records, 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,” according to an accompanying editorial from Susan Hingle, MD, of Southern Illinois University.

“Electronic health records were implemented to improve the efficiency and quality of patient care, but they have yet to achieve that promise,” Hingle adds.