Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations

Primary care physicians spend nearly 2 hours on electronic health record (EHR) tasks per hour of direct patient care. Demand for non-face-to-face care, such as communication through a patient portal and administrative tasks, is increasing and contributing to burnout. The goal of this study was to as...

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Veröffentlicht in:Annals of family medicine Jg. 15; H. 5; S. 419
Hauptverfasser: Arndt, Brian G, Beasley, John W, Watkinson, Michelle D, Temte, Jonathan L, Tuan, Wen-Jan, Sinsky, Christine A, Gilchrist, Valerie J
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.09.2017
Schlagworte:
Adult
Burnout, Professional - etiology
Electronic Health Records - statistics & numerical data
Female
Humans
Male
Middle Aged
Physicians, Primary Care - psychology
Physicians, Primary Care - statistics & numerical data
Primary Health Care - methods
Retrospective Studies
Time and Motion Studies
Workload - psychology
Workload - statistics & numerical data
primary care
workload
electronic health records
health information technology
burnout
practice-based research
ISSN:1544-1717, 1544-1717
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Zusammenfassung:Primary care physicians spend nearly 2 hours on electronic health record (EHR) tasks per hour of direct patient care. Demand for non-face-to-face care, such as communication through a patient portal and administrative tasks, is increasing and contributing to burnout. The goal of this study was to assess time allocated by primary care physicians within the EHR as indicated by EHR user-event log data, both during clinic hours (defined as 8:00 am to 6:00 pm Monday through Friday) and outside clinic hours. We conducted a retrospective cohort study of 142 family medicine physicians in a single system in southern Wisconsin. All Epic (Epic Systems Corporation) EHR interactions were captured from "event logging" records over a 3-year period for both direct patient care and non-face-to-face activities, and were validated by direct observation. EHR events were assigned to 1 of 15 EHR task categories and allocated to either during or after clinic hours. Clinicians spent 355 minutes (5.9 hours) of an 11.4-hour workday in the EHR per weekday per 1.0 clinical full-time equivalent: 269 minutes (4.5 hours) during clinic hours and 86 minutes (1.4 hours) after clinic hours. Clerical and administrative tasks including documentation, order entry, billing and coding, and system security accounted for nearly one-half of the total EHR time (157 minutes, 44.2%). Inbox management accounted for another 85 minutes (23.7%). Primary care physicians spend more than one-half of their workday, nearly 6 hours, interacting with the EHR during and after clinic hours. EHR event logs can identify areas of EHR-related work that could be delegated, thus reducing workload, improving professional satisfaction, and decreasing burnout. Direct time-motion observations validated EHR-event log data as a reliable source of information regarding clinician time allocation.
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SourceType-Scholarly Journals-1
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ISSN:1544-1717
1544-1717
DOI:10.1370/afm.2121