- As a physician, free time is a scarce enough commodity without having to factor in convoluted EHR workflows and frozen computers, but a large number of providers surveyed by the American College of Physicians (ACP) are still reporting significant productivity losses due to their EHR technology. In a letter published in JAMA this week, participants in the poll reported an average of 48 minutes lost each day to EHR woes including sluggish record retrieval and cumbersome documentation processes.
Researchers from the ACP and National Institutes of Health surveyed more than 400 physicians and trainees from a wide variety of practice types. The providers used 61 different EHR systems, with three-quarters of the respondents using one of nine most popular products. Eighty-two percent had been using their EHR systems for more than a year, and 70% reported being familiar with a broad range of functionalities.
Despite the fact that most participants were experienced EHR users, their dissatisfaction with the impact of the technology on their daily workflow was clear. Just under 90% of participants reported that at least one data management function was slower after implementing an EHR, with 63.9% stating that writing clinical notes took longer with the electronic system. A third added that finding and reviewing data, including notes authored by other physicians, took longer with the EHR than without.
Nearly 60% of providers reported losing time to their EHRs. Of those providers, the mean loss was 78 minutes per day, or 6.5 hours per five-day week. The entire cohort of responding attending physicians, including those who didn’t signal that EHRs slowed them down, reported a mean loss of 48 minutes per day to EHR technology, while trainees only dedicated 18 minutes of extra time to their keyboards. Providers who reported using the VA’s Computer Patient Record System (CPRS) experienced the least loss of free time with an average of just 20 minutes.
“The loss of free time that our respondents reported was large and pervasive and could decrease access or increase costs of care,” the letter concludes. “Policy makers should consider these time costs in future EMR mandates. Ambulatory practices may benefit from approaches used by high-performing practices – the use of scribes, standing orders, talking instead of email – to recapture time lost on EHR. We can only speculate as to whether better computer skills, shorter clinic assignments with proportionally less exposure to EMR time costs, or other factors account for the trainees’’ smaller per-day time loss.”