What You Should Know:
– A recent study reveals that telemedicine is related to increased EHR time for physicians in the ambulatory setting, primarily due to documentation of visits, and may require adjustments in productivity expectations and strategies to address EHR documentation burden for physicians in healthcare systems.
– The longitudinal cohort study of 1052 ambulatory physicians conducted at UCSF Health analyzes the time physicians spent working in the EHR during patient scheduled hours (PSH) from two one-year periods: one before the COVID-19 pandemic (August 2018-September 2019) and one after its onset (August 2020-September 2021).
Comparing the period before to the period after the pandemic onset reveals that physician time spent working in the EHR during PSHs:
– increased from 4.53 to 5.46 hours per 8 PSH (difference, 0.93; 95% CI, 0.87-0.98; P < 0.001)
– outside of PSHs, increased from 4.29 to 5.34 hours (difference, 1.04; 95% CI, 0.95-1.14; P < 0.001)
– time documenting during and outside of PSHs increased from 6.35 to 8.18 hours (difference, 1.83; 95% CI, 1.72-1.94; P < 0.001).
– Mean weekly messages received from patients increased from 16.76 to 30.33, and messages sent to patients increased from 13.82 to 29.83.
– In multivariable models, weeks with a mix of face-to-face and telemedicine (β, 0.43; 95% CI, 0.31-0.55; P < .001) visits or entirely telemedicine (β, 0.91; 95% CI, 0.74-1.09; P < .001) had more EHR time during PSHs than all face-to-face weeks, with similar results for EHR time outside of PSHs.
Addressing Physician Burnout
The study suggests that health systems may need to adjust productivity expectations for physicians and implement strategies to alleviate EHR documentation burden.