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

We opened a survey to PAA members and the public in an effort to learn more about an unexplored topic in the world of EHRs: How much additional time does your EHR add to your day? Anecdotally, we hear many complaints from clinicians about having to spend hours at the end of every day in order to (try and) maintain their previous patient volume. Or…does the practice become less productive? How pervasive is the problem?

We heard from over 250 respondents around the country. The response was strong enough to allow us to feel confident in many of the general conclusions we made but we are wary jumping to conclusions regarding some of the more specific results. We will share our data and let you decide.

First let us describe the respondents. Over 65% are owners of the practices with the remainder being employed by independent or hospital/system owned groups. The specialty mix closely mirrors PAA membership featuring: (1) Pediatric, (2) Family Medicine and (3) Internal Medicine practices.

To our surprise, over 20 different EHR vendors were identified. PAA’s vendor partner, PCC, shared the survey with their clients to help us gather information and their clients comprised 26% of the total respondents. The most popular remaining vendors were, in order, Allscripts (7%), eCW (7%), Office Practicum (6%) and Greenway/Vitera (4%).

We also wanted to learn a little bit more about how clinicians are interacting with their EHRs. Eighty five percent of the respondents self-identified as “comfortable or strongly comfortable” with technology. And surprisingly, 80% said that they prefer electronic to paper. In light of the results, we are quite surprised by this figure.

The first question we asked about EHR performance was: “Each day, I spend the following amount of time charting after I’ve seen my last patient…” We realize that it varies from day to day, as many remarked, but we were searching for a rough estimate or guide to the impact of EHRs on clinician time. As you can see, 65% of the respondents spend less than 60 minutes charting at the end of the day. We can’t say for sure if this is a good or bad number. But the 35% who spend 60 minutes or more every day on their end of day charting must be feeling the pain of EHR use.


Time Spent Charting


Among the many interesting comments we received about this question, these stand out:

“And I resent this use of my time more than I can say.”

“I have determined that I require 3 minutes extra per patient to complete charting. Three minutes seems like nothing! It takes me more time to mix my coffee. But 3 minutes times 35 patients...well, you do the math!”

 “The extra time is spent DURING the visit. It slows down the visit.”

We then wanted to see how clinicians feel about their productivity on EHR. Note that we didn’t define productivity. Every clinician has a different measure or gut level response to this question. We literally wanted to measure how clinicians “feel,” whether they think of productivity as the number of patients seen, dollars charged or CPT codes generated.

We asked: “Since I began using my current EMR system, my productivity has…”


Productivity Chart


And we wonder why clinicians dislike their EHRs! When 46% of users consider their productivity to have decreased and 74% say their productivity is the same or worse after expending a great deal of time and money, this “dislike” should not be a surprise. And now we have some data to substantiate their concerns.