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Docs in these specialties spend more time on EHRs, study finds

Physicians on average spend 16 minutes per patient visit on EHRs, but that number varies dramatically between specialties, an Annals of Internal Medicine study found.

Today’s physicians spend, on average, 16 minutes per patient encounter dealing with electronic health records, a new study in the Annals of Internal Medicine found.

The study examined EHR use among 155,000 physicians working in 417 health systems over the course of 2018. In total, the data set encompassed roughly 100 million patient visits.

Researchers only looked at use of the Cerner Millennium EHR system, which means physicians using different EHR systems may spend different amounts of time on them. However, physicians having to spend significant amounts of time on EHRs is widely understood to be a contributor to high burnout rates, which suggests that these usage trends may be similar to those for physicians on other EHR systems.

The researchers also found that time spent on EHRs differed significantly between specialties. Physicians in the following specialties spend the most time on EHRs—up to 18-22 minutes per patient encounter, according to Fierce Healthcare’s coverage of the study:

Specialties that spend more time on EHRs

  • Gerontology
  • Endocrinology
  • Primary care
  • Internal medicine

Conversely, physicians in the following specialties typically spend significantly less time on EHRs than the average physician.

Specialties that spend less time on EHRs

  • Sports medicine: 8 minutes per patient visit
  • Physical medicine and rehabilitation: 10 minutes per patient visit

This study’s large size and inclusion of multiple specialties may provide the final word on the question of how much time the average physician spends on EHRs, with the answer being 16 minutes per patient visit, wrote Julia Adler-Milstein, PhD, in an editorial Annals published in conjunction with the study.

“Is [16 minutes per patient visit] too much time? The broader literature is debating this,” she wrote. “People who say ‘yes’ point to physician burnout, poor EHR usability, and the underlying documentation requirements for reimbursement (particularly for evaluation and management). The ‘no’ camp is harder to characterize but certainly contains the many diverse consumers of EHR data—in particular, those who use these data for research that fuels discovery in a range of domains that improve health and health care.”

The study abstract is available here; an excerpt of the editorial is available here.

7 comments

  1. So if you work 8hr day in internal
    Medicine or primary care and see average of 4 patients an hr, you will then spend and additional (8×4) x22min on the computer when you complete your 8hr work day………. an additional
    706 min on computer??????????

    1. I think the math is wrong in your comment.
      8 min per pt X 24 patients = 192 minutes or 3.2 hours.
      I think many docs like myself spend any free time minutes catching up on records during the day, so by leaving time all is done.
      I cannot see as many patients so have to be as efficient as I can during the day.

      1. Yes. You work 12 hours (including breaks between patients and EHR notes otherwise your fingers will cramp and you have zero time for the restroom and food).

        But you get paid for 8 hours. Or even less – such as with Medicaid and Medicare.

  2. The wisdom of EMR adoration. This helps explain the familiar “Doctor you are running behind”. Even booking THREE patients hourly….22 x 3 = 66 minutes per hour …Whoops, where is time for interviewing and examining the patient??

    1. Family physicians have only 6 minutes to see a patient otherwise they can go bankrupt.

      So they see 10 patients an hour – or generally up to 60 an 8 hour day – with breaks to prevent burnout.

      But then, 60 patients x 22 minutes on the EHR = 22 extra hours on the EHR PER DAY.

      This is obviously an impossible situation.

  3. I’m an otolaryngologist. Even though I dictate into the EHR, I still spend an average of 10 to 15 minutes per patient. But what upsets me is having to read the 10 page fine print referral note from the primary physician, trying to understand why this patient is in my office. It used to be a prescription form asking me to test someone’s hearing, or please remove little Joe’s tonsils. Now, it is a 10 page dissertation and one page about cholesterol tests. Patients get upset when I ask them questions: “Well didn’t my PCP explain to you why I am here?”

  4. Patients hate EHR’S.They resent the fact that the physician spends most of the visit time, on the computer and very little time on their medical problem and exam.
    EHR’S are the worst nightmare for physicians.
    Most physicians cannot type or are very slow. Time is money.
    Money is reduced daily by Insurance Companies, Medicare and Medicaid.
    Default Templates are too long. Physicians don’t have time to read the whole “essay”. Time is money. They have to see fixed number of patients per hour or day. Or they don’t get paid.
    That is going to lead to Malpractice when things get missed.
    Cost of installing and maintaining EHR’S is prohibitive.
    Doctors are the only profession that are getting les and less reimbursement for their services while overhead keeps going up with so many mandates. EHR’S, MIPS, ACO, etc.
    What is AMA doing for the doctors?
    So sad to see physicians burning out, retiring early per force because they cannot keep up the expenses, becoming salaried employees of hospitals, Venture Capital and Private Equity Groups.

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