Are Electronic Health Records Stealing Physician Time From Patients?
Medical recording processes have existed since the fifth century B.C. What was then a paper-based process has evolved into an electronic-based system that we use today, known as electronic health records (EHR).¹
“The EHR includes the electronic medical record [digital version of a patient’s chart, used in a physician’s practice to diagnose and treat patients], and also includes mechanisms for sharing data amongst various healthcare organizations.²”
The use of EHRs has meant greater efficiency to the PCP work cycle - billing, scheduling, record keeping and analysis of data. Continued advances to the technology, as well as adoption as a result of mandates and government funded incentives, have led to widespread use of EHRs, with 80% of U.S. hospitals reporting use as of 2015, up from 17% in 2008.³
The question remains however, whether EHR's gains in efficiency come with negative side-effects for the physician-patient interaction. A long-held belief has been that physicians do not spend enough time with patients, do EHRs further exacerbate this problem?
A recent study published in Family Medicine was particularly interested in observing the impact EHR has had on physician-patient face time. The study claims that PCPs spent more time working in the EHR than they spent face-to-face with patients during clinic visits.⁴ From the 982 physician-patient visits observed in the study, the average time spent by the physician per visit* was 35.8 minutes. Within this duration, the estimated average of time spent per visit in the EHR system was 18.6 minutes. The study’s conclusion is that time spent in the EHR outweighs the amount of time the physicians are spending face-to-face with the patient by about 2 minutes (18.6 vs. 16.5). However, a closer investigation of time physicians are spending with patients reveals that patients are actually getting more face-to-face time than not once the actual examination begins. The average time spent during the “examination” is 26.0 minutes, with 16.5 of those being face-to-face, 8.8 spent within the EHR, and .7 spent non-face-to-face outside the EHR. Physicians may be observing longer work days and a more skewed work-life balance in pursuit of better dedication to “visits,” but patients are remaining the focal point of “examinations.”
Ultimately, while EHR activity has not exceeded patient face-to-face time, there is certainly room for platform improvement.⁵ Though today’s physician-patient interaction may be different from years prior, future EHR enhancements will lead to a continued commitment of placing the patient experience at a premium. As technology becomes more streamlined and workflow friendly, time spent in the EHR for administrative related activity will continue to decline. This will allow for more physician-patient interaction time overall, and an even greater patient focus.
*Factoring in time prior and subsequent to patient being seen by the doctor, as well as time the physician spends with the patient
[2]: WPP Health & Wellness_EHR Playbook_11/2017
[4]: https://journals.stfm.org/familymedicine/2018/february/young-2017-0121/
[5]: https://ehrintelligence.com/news/physician-ehr-use-workload-trumping-face-time-with-patients
All sites accessed March 2, 2018. Information is accurate as of the time of writing.
This story was originally published on June 27, 2018 on ghgroup.com