Family medicine residents at two academic medical centers in California ended up spending an extra 16 minutes on documentation after implementing an EHR, according to a study presented by Dr. Maisara Rahman at a recent meeting of the American Academy of Family Physicians. Productivity losses from EHR use has been one of the greatest fears of physicians since the EHR Incentive Programs began, but researchers are just beginning to quantify exactly what kind of hit providers can take from the added burdens of pointing and clicking.
“We have learned about how electronic health records are going to improve our patient care and our efficiency in the clinic but not a lot of studies have explored how the implementation of an electronic health record at academic centers is going to impact resident education,” Dr. Maisara Rahman said to Family Practice News.
Resident physicians at Riverside County Regional Medical Center (RCRMC) saw a 30% drop in daily productivity after installing an EHR, and participants at Pomona Valley Hospital Medical Center (PVHMC) experienced a 20% slower work day. Respondents said that while completing a paper chart took an average of 21 minutes, using the EHR lengthened the time to 37 minutes. Residents also noted that they missed an average of two lecture sessions a month due to the extra time they needed to work within the EHR. Residents also added an extra 45 minutes to their clinic duties, cutting into their personal time, to complete notes for a typical half-day clinic shift. ”That’s pretty significant,” Dr. Rahman said.
A separate study conducted by Dr. Alan Bank of United Heart and Vascular Clinic in St. Paul, Minnesota found that using a trained medical scribe to complete charting and documentation before the visit allowed physicians to cut down the time necessary for a patient consult by one-third. “With the EHR, we had to leave one open 20-minute slot every four hours because the doctors couldn’t keep up. So we were each losing two patients a day,” he explained to EHRintelligence. “Our doctors who use scribes now don’t have to leave that 20 minute slot open. I’m seeing 27% more patients than my partners without a scribe.”
“Resident satisfaction with EHR implementation was highly correlated with whether the respondents had adequate EHR training,” Rahman noted. “When we compared the residents from the two academic sites, we noticed that a lot of the RCRMC residents were not satisfied and were not happy with the system. They were less efficient and less productive in clinic, and it was correlated to the training hours. This is most likely related to RCRMC being a county facility and there are fewer resources to provide adequate EHR training for residents.” source
