EMRs Taking Away Close to One-Third of Physicians’ Work Time – AMA
The EMR Time Crunch
A common complaint among physicians across practices and specialties has been the amount of time that was previously spent attending to patients is now being occupied by clinical documentation. These time disparities can have adverse effects on physician-patient relationships, and also limit the number of patients able to receive care from a physician or practice. Value-based purchasing models are frequently the basis for physician reimbursements, and because these models require extensive documentation to accurately report the quality and cost of care, the EMR software physicians are required to use is becoming increasingly complex and time consuming.
AMA Findings
A recent study conducted by the American Medical Association focusing specifically on the use of electronic health records in academic centers concluded that an average of 27% of the participating Ophthalmologists’ time spent on patient examinations was occupied by EMR use. On average a total of 5.8 minutes per patient and 3.7 hours was spent working in EMR on any given full day of clinic. The study also found a negative association between the amount of time spent on EMR per patient encounter and overall clinic patient volume.
The AMA study concluded what many physicians have been expressing for years: doctors have limited time to spend with patients while they are spending more time within EMRs. Aside from the strain EMR places on physicians’ time and patient relationships, it is also creating cumbersome clerical burdens when completed incorrectly or hastily. Large swaths of copied and pasted text create bloated and messy records, and a lack of training and technical knowledge can result in incorrect coding, medical errors, and frequent interruptions in the documentation process.
Physician Dissatisfaction
The amount of physician dissatisfaction has also grown with the increased implementation of EMRs. Nearly half of all physicians report feeling unsatisfied with their work-life balance, and 57% of physicians display signs of burnout. The additional time requirements of clinical documentation are a significant factor in both of these statistics. Physicians are spending an increasing amount of time outside of regular work hours completing EMRs, and an increasingly less amount of time on actual patient care and interaction. This has led to heightened levels of stress and job dissatisfaction.
Looking Forward
While the path hasn’t always been an easy one, electronic medical records are here to stay, and they do present a plethora of benefits to clinical documentation, patient care, and bottom lines. The challenge that needs to be addressed is how to make EMRs efficient and thorough, while minimizing the amount of time physicians are required to spend on them. Perhaps the solution for better EMR efficiency lies within a hybrid workflow — a workflow that combines the traditional model of medical transcription, where physicians dictate patient encounters and trained transcriptionists and coders review the reports for accuracy and sufficiency, combined with the advantages of using a modern day EMR is the most efficient way to ensure document quality and lessen the time burden EMRs place on physicians. When the responsibility of clinical documentation is not placed solely on the physician, doctors will be able to attend to more patients, improve patient relationships, and increase their job satisfaction.
Center for Medicare & Medicaid Services (CMS) has released its Final Rule for Hospital Outpatient Prospective Payment System OPPS) for CY2017 with significant implications to hospital outpatient departments.