A study published in Annals of Internal Medicine reveals that doctors spend about three times as much of their workday on a computer than they do talking with and examining patients.
What’s even more disturbing is that in the context of previous research on this issue, it’s a problem that seems to be getting worse.
In the latest study, researchers followed internal medicine physicians at a Swiss teaching hospital. They found that the doctors frequently worked overtime – about two extra hours per day beyond the 10 hours scheduled.
“The structure of a resident’s workday has changed dramatically in recent decades, with limitations on hours worked per week, wide implementation of electronic medical records (EMRs) and a growing volume of clinical data and administrative tasks,” Annals reported in a news release. “A recent study found that physicians use about 50 percent of their time using EMRs, but few time and motion studies have focused on how computer use affects resident’s time allocation. This is important because less time spent with patients decreases physician satisfaction and patient education and health promotion and increases inappropriate prescribing and medical malpractice.”
In a 2014 Healthline News report, Dr. Paul Weygandt, vice president of physician services at Nuance, which makes software to help doctors interact more easily with EMRs (referred to as EHRs, or electronic health records in the U.S.), said, “At this point in time, many physicians are spending way too much time dealing with documents instead of patients, and we’ve reached a tipping point.”
About the EHR, Dr. John Halamka, chief information officer at Beth Israel Deaconess Medical Center in Boston, told Healthline, “We are in the biplane era (of EHRs). We haven’t invented the jet engine yet, but we’re not in the era of Wright Brothers, either.”
Time-Saving ‘Copy-and-Paste’ Errors are Common
A recent study led by Dr. Christine Sinsky of the American Medical Association found that “Physicians spent 27 percent of their time in their offices seeing patients and 49.2 percent of their time doing paperwork, with includes using the electronic health record (EHR) system,” Forbes reported. “Even when the doctors were in the examination room with patients, they were spending only 52.9 percent of the time talking to or examining the patients and 37 percent doing…you guessed it…paperwork. Moreover, the doctors who completed the after-hours diaries indicated that they were spending one to two hours each night doing – drum roll please – paperwork (or the EHR).”
These findings mirror the Swiss study. “These numbers show that the amount of paperwork may be getting worse over time,” Forbes went on to report. “Previous estimates such as from this 2005 study in Annals of Family Medicine were that paperwork consumed a third of physicians’ time. Thus, in a decade, paperwork has gone from being a large chunk to most of a doctor’s time.”
In a study published in JAMA Ophthalmology, researchers found “significant inconsistencies between what symptoms patients at ophthalmology clinics reported on a questionnaire and documentation in the electronic medical report,” the medical journal reported in a news release. The report said that while only 18 percent of physicians were using EHRs in 2001, by 2014 that number had ballooned to 83 percent.
In an accompanying editorial, Dr. Christina Y. Weng of Cullen Eye Institute at Baylor College of Medicine in Houston wrote, “Electronic medical records have created unique, unprecedented issues like ‘adjacency errors,’ whereby a clinician inadvertently selects an item next to the intended one from a drop-down menu, thereby placing an order for the incorrect drug or imaging study. Even more common are copy-and-paste errors in which medical personnel carry forth outdated data from a previous encounter. In a 2008 physician survey, 90 percent of physicians used the copy-and-paste functionality in daily progress notes.”
While EHRs have the ability to harness big data and put it to good use to find cost-saving and life-saving measures in healthcare, they only are as good as the accuracy of the information within them. And while patient satisfaction increasingly is tied to doctor reimbursement, chances are patients aren’t too fond of having their doctor’s nose in a computer instead of having their attention directed at what ails them.