Gastroenterology Providers Spend an Additional 45–50 Minutes on Electronic Health Records Per Hour of Scheduled Time

Nearly 50% of US physicians exhibit signs burnout,1Shanafelt T.D. West C.P. Sinsky C. et al.Changes in burnout and satisfaction with work-life integration the general working population between 2011 2017.Mayo Clinic Proc. 2019; 94: 1681-1694Abstract Full Text PDF PubMed Scopus (414) Google Scholar a condition associated dissatisfaction balance, substance abuse, reduced quality care, decreased productivity.2West Dyrbye L. Shanafelt T. Physician burnout: contributors, consequences solutions.J Intern Med. 2018; 283: 516-529Crossref (817) Burnout its are also prevalent among physician assistants nurse practitioners, collectively referred to as nonphysician providers.3Edwards S.T. Marino M. Balasubramanian B.A. al.Burnout physicians, advanced practice clinicians staff smaller primary care practices.J Gen 33: 2138-2146Crossref (43) Electronic health records (EHR) have been implicated provider burnout; by contributing volume work that cannot be routinely completed during scheduled hours, EHR adversely impacts balance.4Friedberg Chen P. Van Busum K. al.Factors affecting professional their implications for patient systems, policy.Rand Health Q. 2014; 3: 1PubMed There limited data on time spent providers. Two studies report spend an additional hour per office time;5Tai-Seale Olson Li J. al.Electronic record logs indicate split evenly seeing patients desktop medicine.Health Aff. 2017; 36: 655-662Crossref (174) Scholar,6Arndt B. Beasley Watkinson al.Tethered EHR: workload assessment using event log time-motion observations.Ann Fam 15: 419-426Crossref (379) similar results reported across multiple specialties.7Sinsky Colligan al.Allocation ambulatory practice: motion study 4 specialties.Ann 2016; 165: 753Crossref (694) Scholar,8Momenipour A. Pennathur Balancing documentation direct activities: mature electronic system.Int J Ind Ergonom. 72: 338-346Crossref (9) Gastroenterology has unique schedule, workflow, requirements, different from those other specialties. Despite this, there no published analyzing gastroenterology This aims quantify providers EHR, better understand role use burnout. was reviewed Institutional Review Board, waiver obtained. Time calculated each large, multispecialty group is part community-based system Northern California. Raw audit Epic were collected over 8-week period February 3, 2019 March 30, 2019. The monitors piece protected information accessed user. into 5-minute intervals; if at least 1 logged given interval it considered EHR. methodology accurately estimates because typically contiguous blocks. Cumulative same period, visit Epic. Office-based surgery center appointments included analysis (hospital-based not available). Contracted pediatric gastroenterologists, full-time equivalent status <0.2, new group, without available scheduled-time excluded. Ratios calculated. We analyzed status, postfellowship experience, intervals. Data 23 7373 encounters (3465 visits, 310 office-based procedures, 3598 center) sites. As shown Table 1, average weekly 41.30 ± 11.73 24.48 7.64 hours. ratio 1.78 0.70.Table 1Provider CharacteristicsCharacteristicsPhysicians (n = 23)Nonphysicians 3)Male17 (73.91)1 (33.33)Full-time11 (47.83)2 (66.66)Experience after fellowship, y13.61 8.60N/ANew interval, min43.04 10.0840.00 8.66Average h41.30 11.7332.87 10.99Average time, h24.48 7.6418.94 7.23Ratio time1.78 0.701.80 0.49NOTE. presented n (%) or mean standard deviation unless otherwise noted.EHR, record; N/A, applicable. Open table tab NOTE. noted. 3 733 visits. 32.87 10.99 18.94 7.23 1.80 0.49. To our knowledge, this first quantifying practice. found 0.70 0.49 providers, indicating 45–50 minutes EHR-related tasks. These findings consistent previous showing aggregate specialties.5Tai-Seale Scholar, 6Arndt 7Sinsky 8Momenipour Another notable finding hours does take account hospital-based actively (eg, undivided attention conversation examination). In addition, significant proportion studied part-time. A limitation we only center–based data; unavailable study. shows outside Future research needed distribution tasks, how targeted countermeasures, such scribe use, could help reduce burden risk burnout.4Friedberg