EHRs and clerical tasks make the care environment more complex and contribute to physician burnout
CHICAGO — Technological and administrative obstacles are significantly cutting into available time for physicians to engage with patients. Nearly half a physician's office day is now filled by data entry into electronic medical records (EHRs) and administrative desk work, according to a new time-motion study conducted by experts at the American Medical Association (AMA) and Dartmouth-Hitchcock health care system. The study results were published today in the Annals of Internal Medicine.
"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," said AMA Immediate Past President Steven J. Stack., M.D. "Unfortunately, these demands are not being reconciled with patient priorities and clinical workflow. 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."
During the office day, the study found 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 deskwork activities. In other words, for every hour of direct clinical face time to patients, physicians spend nearly two hours of additional time on EHR and deskwork within the office day. Outside of office hours, physicians spend another one to two hours of personal time each night on data entry demands.
Dr. Stack highlighted the new study in a presentation to entrepreneurs at MATTER, a Chicago-based health care technology incubator and partner in AMA's effort to have physicians play an influential role in leading innovations that move health care forward. Dr. Stack noted the findings demonstrate the importance of relying on physician experience to bridge the gap between technology design and the realities of patient care.
"I am not surprised to hear these results, and I can tell you no one who practices medicine today would be surprised by them," Dr. Stack said to the entrepreneurs at MATTER. "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."
Today's study quantifies a previous AMA study with RAND Corp. confirming that poorly designed EHRs and administrative obstacles to providing patients with high-quality care are leading contributors to physician burnout. Collaborative studies by the AMA and Mayo Clinic found physician burnout is a growing problem with 54.4 percent of physicians reporting at least one symptom of burnout in 2014, up from 45.5 percent in 2011. In comparison, prevalence of burnout among the general working population was about 28.5 percent.
Responding to the urgent need for better designed EHR systems, the AMA continues to advance a framework of eight priorities for improving EHR usability to benefit caregivers and patients. Physicians believe it is a national imperative to reframe the design and configuration of EHR technology to emphasize the following priorities:
- 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
The AMA has made the well-being of the physician workforce a top priority in national discussions on patient care and health policy, while turning toward healing our profession. As part of this initiative, AMA has created STEPS Forward, an ambitious online practice transformation series launched last year that offers modules to help physicians learn their risk factors for burnout and adopt proven solutions by physicians for physicians that reignite professional fulfillment and resilience.
Through its ongoing work, the AMA is committed to help physicians and their practices thrive so they can continue to put patients first. By advancing initiatives that enhance practice efficiency, professional satisfaction, and the delivery of care, the AMA is striving to help physicians navigate and succeed in a continually evolving health care environment.
Robert J. Mills
ph: (312) 464-5970
About the American Medical Association
The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care. The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care.