Corroborating what practicing physicians have claimed, a recent study published in the Annals of Internal Medicine found that during office hours physicians spent nearly 50 percent of their time on electronic health record (EHR) tasks and desk work.
Researchers concluded that for every hour physicians provide direct clinical face time to patients, nearly two additional hours are spent on EHR and desk work within the clinic day. Outside of office hours, physicians spend another one to two hours of personal time each night doing additional computer and other clerical work.
The time and motion study, led Christine Sinsky, M.D. and her colleagues from the American Medical Association, was funded by the AMA.
The study was based on observations of 57 physicians who work in ambulatory care in four specialties—family medicine, internal medicine, cardiology and orthopedics, in four states, Illinois, New Hampshire, Virginia and Washington. Researchers observed how much time physicians spent on four specific tasks, direct clinical face time, EHR and desk work, administrative tasks and other tasks and self-reported after-hours work.
Researchers observed that during the office day, physicians spent 27 percent of their total time on direct clinical face time with patients and 49.2 percent of their time on EHR and desk work. While in the examination room with patients, physicians spent 52.9 percent of the time on direct clinical face time and 37 percent on EHR and desk work. In addition, about one-third of the physicians also completed after-hours diaries and they reported one to two hours of after-hours work each night, devoted mostly to EHR tasks.
In an accompanying editorial published in the Annals of Internal Medicine, Susan Hingle, M.D., from SIU School of Medicine, wrote, “Sinsky and colleagues confirm 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.”
I'm a Luddite. I do not use emr/ehr and I've got all of my medical records on paper. During Hurricane Irma when my office had no electricity and no internet for 8 days, it would have completely impossible to access patient records if I had been using one. My paper charts by a window letting in natural light worked. I was able to see a few patients in those conditions and I was able to diagnose, write notes, and write prescriptions, all on paper.
Another patient came to me just last week asking I had received results from her internist. I had not. The patient was seen by her internist for a routine check up and a skin lesion was noted on her leg, which the internist took a culture of said lesion and put the patient on an oral antibiotic. The patient asked the internist to fax those details and results/records to me. The internist, whom I have had interactions with in the past and uses Mod Med, told the patient that due to his being so behind on his electronic notes he wouldn't guarantee that he would be able to get those records to me by fax. That had occurred 10 days prior to my visit with this patient.
On the day I saw the patient, I had no information about the relevant and important medical encounter because the doctor was too behind on the electronic tasks placed in front of him.
EMR’s hurt patients and physicians, after all, the Health Information Technology (HIT) company which sold us our EMR system, an expensive EMR used by 35% of the US dermatologists, had assured us that their software and hardware would make our practice more efficient, productive, safer, improve our outcomes and speed compliance with new Federal Regulations to avoid a host of looming Federal penalties and enhance value based care (outcomes/costs). The company only rents access to its software to physicians from the highest reimbursed medical specialties. Their advertisements and marketing state that their EMR is, "Transforming how healthcare information is created, consumed & utilized to increase efficiency & improve outcomes".
THESE ARE PITHY MORSELS FROM----
Michael Sherling, MD, MBA
CHIEF MEDICAL AND STRATEGY OFFICER
Dr. Michael Sherling is the co-founder and Chief Medical and Strategy Officer of Modernizing Medicine. In 2014 Michael, along with Dan Cane, received the U.S. Chamber of Commerce’s Leadership in Healthcare Award.
Michael is responsible for the strategy and medical innovation within Modernizing Medicine’s suite of products and services for dermatology, gastroenterology, ophthalmology, orthopedics, plastic surgery, otolaryngology and urology specialties. With Dan Cane, he has developed novel software solutions for EHR, MIPS and ICD-10 automation.
Under his leadership, Modernizing Medicine has established a user base of over 10,000 providers and raised over $318 million in capital.
Michael is a dynamic speaker and has had the honor of speaking at the 2017 Association of Dermatology Administrators & Managers (ADAM) Annual Meeting, the 2016 Dermatology Entrepreneurship Conference and 2015 Health 2.0 Conference’s “Tools to Fix the Clinical User Experience.”
Michael has been a practicing dermatologist since 2006 and currently practices in a comprehensive skin care dermatology group in Palm Beach County, Florida. Michael also serves on the Advisory Board for the Florida Atlantic University Charles E. Schmidt College of Medicine. Michael is board certified by the American Board of Dermatology. Prior to relocating to Florida, he was the Associate Director of Laser Medicine and Skin Health at Brigham and Women’s Hospital in Boston and served as the Associate Residency Program Director for Harvard Medical School’s Department of Dermatology. He has several publications in peer-reviewed medical literature.
Michael obtained his BS in Biology at Brown University with honors in 1996, his MD from Yale School of Medicine with honors in 2002 and his MBA from Yale School of Management in 2002. He received his clinical training at Harvard Medical School, where he served as chief resident in dermatology
ANOTHER PHYSICIAN STORY: the EHR links to Amazon and sends emails to the patient on the OTC recommended by the physician!!!
" The liability for interfering with optimal outcomes with EHR company linked OTC product purchases is borne solely by the physician, and the revenue for sales of Amazon's OTC products shared solely by the EMR company and Amazon.
Whose data is it anyhow, the patient's? the doctors'? the government or the EHR companies? Our EHR Company claims all the chart data is theirs."
Oh oh, no straight answers. Nobody knows!!
