waste_timeDoctors complain that they waste an average of 48 minutes a day, or four hours a week, when they record their patients’ health information into digital records, a new study shows.

The results were collected in a small survey, whose findings were put into a letter that was published Monday in the online edition of JAMA Internal Medicine. A draft of the letter was released Monday to a group of health care reporters at the National Library of Medicine. Dr. Clement McDonald, lead author of the study and director of the NLM Lister Hill National Center for Biomedical Communications, presented the letter, “The Use of Internist’s Free Time by Ambulatory Care Electronic Medical Record Systems.”

The findings came from a 19-question survey that the American College of Physicians sent in December 2012 to 900 ACP members and 102 non-members. They received a 53.6 percent response rate; respondents had used 61 different EMR systems.

The mean loss for trainees was lower than the average, at 18 minutes a day. “We can only speculate as to whether better computer skills, shorter (half-day) clinic assignments with proportionately less exposure to EMR time costs, or other factors account for the trainees’ smaller per-day time loss,” the study read.

Time taken to fill out records at the Veteran’s Affairs department was also less, even though the agency has come under criticism as military and veteran patients died while waiting to be seen by health care providers. The agency’s Computer Patient Record System was associated with the least amount of time lost, an average of 20 minutes a day. McDonald says part of the reason for this is that the agency adopted the technology much earlier than the rest of the health care industry.

Hospitals, clinics and individual providers have moved more slowly toward digital use than other industries, such as banking or shopping. President Barack Obama championed electronic health care records during his first presidential campaign, then pushed their implementation to lay the groundwork for the nation’s health care reform package.

To encourage adoption of the technology, doctors and hospitals were given $27 billion in the 2008 economic stimulus, a flood of money the government tried to use to jump-start the economy during the Great Recession.

The money, distributed by the Centers for Medicare and Medicaid Services, was intended to encourage health care organizations to adopt electronic records, and penalize them through lower Medicare or Medicaid reimbursements if they did not comply. The law requires health care providers to demonstrate not only that they are using electronic health records, but that those records meet requirements outlined by the government.

Health care providers are using iPads more frequently, and some have taken on Google Glasses. McDonald says he would like to see health care providers record patient visits, so they can take their diagnosis home to go over it with family members, when they are not overwhelmed in a doctor’s office or hospital with the information they have just been given.

There still are numerous disconnects for implementation, however. Different digital record systems do not work with each other, for example, and doctors can miss visual cues when they are looking at a computer instead of at a patient. Some patients do not understand the systems and think doctors are checking their email during an appointment.

To avoid this, some doctors will talk to patients while scribes type information into a computer, but that is less cost-effective. “Humans like to do things quickly and efficiently,” McDonald says. “You can’t always do something magically faster with technology.”

Proponents of electronic health records say they have the potential to reduce medical errors, better coordinate care, and save time. Some say the technology, however, hasn’t reached that point. “It simply takes longer [to enter patient information into a computer],” says McDonald, who is a proponent of EHRs and was among a group which created the first system in the country. “There is already so much to do and you have to look at patient safety.” Deep consequences can come out of one typo, he adds, and adding another data point carries additional time cost.

McDonald expected the results from the study because he has heard complaints from doctors who said they were spending extra time with EHRs after work, he says.

The time lost, the letter points out, could decrease access to care, given the opportunity cost of meeting with a patient during that time. It also could increase the cost of care. “Policy makers should consider these time costs in future EHR mandates,” McDonald says.



Leave a Reply

Please sing in to post your comment or singup if you don't have account.