Less time seeing patients does not necessarily lead to less time spent on EHR

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Working fewer hours does not necessarily lead to less time spent updating electronic health records (EHRs).

A study of 118 primary care physicians at UW Health, affiliated with the University of Wisconsin, examined whether fewer working hours led to reduced time spent on EHRs.

The results were mixed. Weekly total EHR time, orders, and inbox time consistently decreased as doctors worked fewer hours. But there was no proportional drop in notes, time outside scheduled hours on days with appointments, and time on unscheduled days.

The researchers found “physicians who worked part-time spent more time in the EHR per hour of clinic than their full-time peers, including more time outside scheduled appointments.” Panel sizes, visit volumes, and message volumes did not explain the differences in time.

Physicians with fewer clinic hours disproportionately may fill time outside with inbox work that continues away from clinic work, the authors said.

Physicians working fewer hours may have lower rates of burnout, so more time spent on EHRs may not translate to more burnout. Working on EHRs outside scheduled hours “may allow them to feel caught up or allocate more time for panel management work on afforded to physicians” with more working hours, the study said.

“Given the increasing EHR workload and shortage of (primary care physicians) in the U.S., future efforts should find ways to right-size workload for all (ambulatory full-time equivalents) while allowing sufficient time for the inbox, proactive panel management, and quality improvement without affecting personal or nonclinical work time,” the study said.

“Association of Primary Care Physicians’ Ambulatory Full-Time Equivalencies With Time in the Electronic Health Record” was published in JAMA Network Open.