By - Physicians at large community hospitals spend nearly four hours during work hours, or roughly 40 percent of their day, on the EHR, according to a study published in the Public Library of Science (PLOS ONE).
Additionally, researchers found a significant decrease in resident EHR use with increased training and experience, although the overall amount of time spent on the EHR remained high.
“Studies exploring EHR use emphasized extensive time as one of the significant drawbacks to EHR,” wrote the study authors. “It has been reported that physicians spend up to 6 hours a day on EHR in the hospital setting alone.”
However, the study authors noted many studies that document hours spent on the EHR system are self-reported. Researchers aimed to record data to illustrate how much total time is spent using the EHR and to analyze the levels of clinical experience to see if there is a correlation between hours worked and experience status.
In 2016, researchers conducted the study at New York-Presbyterian Brooklyn Methodist Hospital, a 651-bed tertiary hospital, over a separate two-week time period in the first and fourth quarters.
Researchers evaluated nearly 250 physicians with varying degrees of experience, from interns up to attending physicians. The team defined “EHR active use” as more than 15 keystrokes, three mouse clicks, or 1,700 “mouse miles” per minute. The team recorded total time and percentage of EHR use, along with physician level differences.
On top of tracking EHR use, researchers gave patients a five-question survey based on patient satisfaction and their perspective on physician EHR use.
Researchers found physicians, including attending physicians, residents, and interns, spent an average of 4 hours per day on the EHR, which totaled 37 percent of their respective workdays. When separating the three levels, attending physicians spent 37 percent of their work hours on the EHR, residents totaled the most time on the EHR with 41 percent, and interns spent the most hours on the EHR at 45 percent.
However, clinician EHR use dipped in the fourth quarter to 2.9 hours per day or 30 percent of the workday, primarily due to resident EHR use. This signifies a reduction in use following more experience and training on the EHR.
When gauging patient satisfaction, researchers found a direct correlation between time spent with the patient and resident EHR use. Additionally, they found residents spent more time on the EHR than they do with patients.
“This objectively demonstrates a shift away from the bedside and a greater emphasis on EHR, demonstrating the demands of modern medicine on physicians at every level of training,” study authors wrote. “An important observation of our analysis is that EHR proficiency improves with progression of training, both in regards to seniority and familiarity of EHR. This may in part be attributed to suboptimal initial EHR training.”
However, there was little association between physician EHR use and overall resident happiness.
“The significance of an increasing shift towards EHR is a growing paradigm that cannot be understated, particularly in the current era of healthcare when there is increasing scrutiny on documentation and a ceiling on the number of hours that can be worked by house staff,” the authors continued. “These increased demands can lead to EHR fatigue and physician burnout.”
Increased EHR training and experience for aspiring physicians will ultimately ease EHR use, ideally reducing the amount of time spent using the tool. The authors said reducing EHR time where residents spend roughly two-fifths of their day on the EHR would be a positive step towards reducing provider burden.
“There was a marked reduction in EHR time with both clinician and resident seniority,” the researchers concluded. “Despite this improvement, the total time spent on EHR remained exceedingly high amongst even the most experienced physicians. We did not see a correlation between time spent on EHR by physicians with patient or physician satisfaction.”
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July 15, 2020 at 01:26AM
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