Survey on EMR Time: How Long Does It Take You? Part II

We shared the first round of results from our EHR efficiency survey.  The goal of the survey was to look into one of the not-so-hidden secrets of EHR implementation: the impact on your time and productivity.

We received survey responses from nearly 250 primary care physicians and practices around the country and the immediate feedback confirmed our fears: many practices feel as though EHR has had a negative impact on their productivity and has added significant time to the end of every day.  Yet, the clinicians prefer electronic charting to paper charting. See all the details here.

In this round of results, we're going to dig a little deeper and look into the hearts and minds of the ever-important primary care world.

First, let's examine the possible differences among the specialties. Although our responses weren't distributed evenly (with nearly 75% of the responses coming from pediatricians), we note that the Internists appear to fare worst among their peers when it comes to productivity and time: more than half of them say that their productivity has "decreased significantly" and almost 25% of them spend more than 2 hours at the end of the day charting!

 

Time Spent Charting

Time Spent Charting

Otherwise, the specialties generally aligned with each other on questions of technology comfort, preferred charting methods (paper vs. EHR).

Time Spent Charting

Bigger, and surprising, differences became obvious when we compared the owners/partners of independent practices to employed physicians.

For example, while employed physicians appear to be a little more comfortable with technology - 45% of them identify as "very comfortable" vs. 36% for independent clinicians (see chart) - the independent physicians prefer to use the EHR over paper!

Time Spent Charting

Time Spent Charting

These findings came as a surprise, as we expected that the negative financial impact of EHRs would have greater importance to the independent practices.  We can speculate about at least two explanations:

- EHRs provide non-financial benefits, such as improved quality of care, that have a greater impact on independent practices;

- Employed clinicians are more likely to belong to a larger entity, such as a hospital or health system, and are much less likely to use something that is primary care friendly or even specific to their specialty;

The latter explanation is the most likely when you consider the additional data:

Time Spent Charting

Time Spent Charting

While asking about the EHR, we also took a moment to discuss the most time-consuming and frustrating administrative tasks these primary care practices face.  The results were quite clear: working with insurance companies (claim denials, prior authorizations, etc.) is the most time consuming and frustrating administrative task, with nearly 60% of the respondents identifying it as a top-3 issue (70% when you look at only the independent practices).

Time Spent Charting

EHRs are very likely here to stay. We will not be able to change that. Look for ways to maximize benefits and minimize weaknesses. This may require some adaptations and creativity on the part of the practice and clinicians.

Remember ADAPT, IMPROVISE, OVERCOME.

  1. If you are still on paper or likely switching to another EHR-
    1. Do your due diligence in evaluating an EHR
    2. Learn how to best optimize use of the EHR
    3. Develop templates wherever possible
    4. Make the demonstrator show you each function- have them walk through a patient encounter from making appointment, visit, documentation etc.
    5. Practice, practice, practice BEFORE you purchase
  2. If you have an EHR and are keeping it-
    1. Press the vendor for support and seeking and demonstrating ways to optimize the EHR
    2. Talk" to other practices using that EHR
    3. Attend all User Conferences
    4. Consider using scribes