One-quarter of medical doctors spent less than two hours per day with patients, one of the first studies to use EHR access logs to study physician schedules shows. From MedPage Today.
Doctors have been slow to embrace electronic health records. Even so, the systems now account for about half of the average doctor's day -- demonstrated most recently in a study in the latest issue of Health Affairs.
In one of the first studies to use EHR access logs to study physician schedules, Ming Tai-Seale, associate director of the Palo Alto Medical Foundation Research Institute in California, and colleagues examined time spent on face-to-face medicine versus computer-related activities from 2011 to 2014. They found doctors spent an average of 3.08 hours on direct patient care and 3.17 hours on desktop during this period.
Moreover, computer time inched up over time, from 3.06 hours per day in 2011 to 3.37 in 2014. In-person time stayed about the same.
Progress notes accounted for the largest chunk of digital time, roughly a third of the day, on average. Telephone encounters and secure messages were the next highest activities, together accounting for 15% of the average day.
While the averages tell one story, there was -- perhaps unsurprisingly -- wide variation. The middle two quartiles spent between 2 and 4 hours a day in face-to-face time with patients. The same was true for time spent on the computer.
What that also means is that a quarter of physicians spent less than 2 hours per day with patients; and only a quarter spent more than 4 hours on direct patient care.
The results suggest that fee-for-service plans may need to come up with a new approach, the researchers said. Many of the desktop activities are not reimbursable, which can shortchange patients as well as the doctor.
"Many of those activities -- such as care coordination and responding to patients' e-mail -- are of high value to the delivery system and to patients, so the staffing, scheduling, and design of primary care practices should reflect this value," Tai-Seale and colleagues wrote.