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Physician EHR Use, Workload Trumping Face Time with Patients

A new AMA study shows that physician EHR use takes up nearly 50 percent of providers' day-to-day tasks, outranking patient interaction by nearly double.

By Sara Heath

For every hour physicians spend with patients, they spend another two hours on physician EHR use and deskwork, according to a recent study from the American Medical Association.

The AMA study highlights what many consider the primary issue with the increasing prevalence of physician EHR use: the significant workload the technology adds for providers.

Overall, the study shows that providers spend 27 percent of their total working time interacting face-to-face with patients and 49.2 percent of their time doing EHR or deskwork.

Physicians also spend an average of two hours working on EHR data entry outside of their office hours.

According to Steven J. Stack, MD, a past president of the AMA, these results simply confirm what many in the healthcare space had considered to be true.

"This study reveals what many physicians are feeling – data entry and administrative tasks are cutting into the doctor-patient time that is central to medicine and a primary reason many of us became physicians," Stack said in a press release.

The increased workload is also making providers weary of their patient-provider relationships. Because providers statistically spend less time with their patients than they do their EHRs, they feel as though robust patient care is falling by the wayside.

"Unfortunately, these demands are not being reconciled with patient priorities and clinical workflow,” Stack continued. “Clerical tasks and poorly-designed EHRs have physicians suffering from a growing sense that they are neglecting their patients as they try to keep up with an overload of type-and-click tasks."

Despite the bleak view of health IT these results show, Stack maintains that there is still room for the technology sector to improve healthcare. The former president presented these results at MATTER, a health IT incubator focused on putting providers in control of technology development. Stack used the study results to emphasize the effect those working at MATTER can have.

"I am not surprised to hear these results, and I can tell you no one who practices medicine today would be surprised by them," Stack said. "But they highlight exactly why new technologies that can bring greater efficiencies to medicine are so important, and why physicians have an important role to play in their development."

AMA is working to improve health IT by promoting eight central goals for improving the healthcare system through digital tools:

  • Enhance physicians' ability to provide high-quality patient care
  • Support team-based care
  • Promote care coordination
  • Offer product modularity and configurability
  • Reduce cognitive workload
  • Promote data liquidity 
  • Facilitate digital and mobile patient engagement
  • Expedite user input into product design and post-implementation feedback

By advocating for such a framework, AMA aims to see health technology that can help providers do their jobs more efficiently and effectively, while best serving all of their patient needs.

In a previous interview, Stack noted that EHRs are not all bad, saying that there are indeed some physicians who enjoy working with the tools.

"Electronic health records have a great amount of promise. Many doctors actually enjoy a lot of facets of their EHRs — the ready access to information, the ability to see historical information, the ability to share information with other doctors, other clinicians, and their patients directly so that patients can be more informed,” Stack explained.

“Those are all good things, but there are many other aspects of the EHR that are frustrating. They are inefficient to use. They don't talk to each other. They cost a lot of money. When they crash or go down, it paralyzes our ability to do our work and care for patients."

The key, Stack explained, is designing these systems – and the regulations pertaining to them – to work within provider needs, ensuring that they will not facilitate provider burnout.

Provider burnout is increasingly becoming associated with EHR frustrations. At the start of this year, an InCrowd survey showed that EHR technology was the second most frequent contributor to physician burnout.

Fifty-seven percent of primary care physicians and emergency medicine physicians have felt a sense of provider burnout on account of increase EHR use, the survey found. Nearly three-quarters of providers feel that their practice is not taking action to help mitigate and prevent provider burnout.

Going forward, it may be useful for healthcare institutions, policymakers, and technology developers to work collaboratively to determine a best path forward for physician EHR use and other health technologies.

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