geoffrey modest medical blogs

Another study came out detailing the large excess physician time required when using electronic health records (EHR) for outpatient encounters (see electronic med record timesink AIM2020  in dropbox, or doi:10.7326/M18-3684) Details: --they reviewed 154,719 physicians in 417 health systems during 2018 in adult, nonsurgical, ambulatory practices in the US who used the Cerner Millennium EHR (an associated 98,211,891 patient encounters), focusing on 13 clinical EHR functions     -- practice sites: 34% integrated delivery networks, 30% regional hospitals, 22% physician groups, and 11% academic medical centers     -- they assessed time spent on chart review, documentation, messaging, writing orders, searching for patients/appointment scheduling, med reconciliation, allergies, problems/diagnoses, responding to alerts, health maintenance/preventive care, end-of-visit functions/patient education, and reviewing and updating history [unfortu...

electronic health record and physician burnout G      Geoff A. Modest, M.D. Wed 12/18/2019 7:25 AM Geoff A. Modest, M.D.  A study from the Mayo Clinics found a strong association between perceived electronic health record usability by  physicians  and professional burnout (see  electronic med record MD burnout mayo2019  in   dropbox , or doi.org/10.1016/j.mayocp.2019.09.024 ). Details: -- cross-sectional survey of US physicians from all specialty disciplines from October 2017 through March 2018, using the American Medical Association Physician Masterfile -- 30,456 physicians were invited to do a survey, 5197 (17%) completed it.      -- 1250 (25%) of them were randomly chosen to receive a sub-survey evaluating electronic health record (EHR) usability; (70%) completed it, leaving 870 evaluable results    ...

A recent AMA-sponsored study looked at the amount of time physicians spend on their various tasks, finding that for every hour spent on direct clinical face time care, roughly 2 hours is spent on the electronic health record (EHR) and desk work (see  electronic med record takes time AIM2016  in  dropbox , or doi:10.7326/M16-0961). details: --57 physicians (family medicine, internal medicine, cardiology, orthopedics) were observed for 430 hours in a direct observational time-and-motion study during office hours. In Illinois, New Hampshire, Virginia, and Washington --79% men and 82% were aged 31-60. --21 physicians also completed after-hours diaries for 7 consecutive days --they measured direct clinical face time with the patients, EHR and desk work (documentation/review, test results, meds and other orders), administrative tasks (insurance and scheduling), and other tasks (bathroom breaks, nonpatient care meetings, pr...

a small study was just published as a research letter looking at the impact on  patient   satisfaction  when providers use computers in the exam room (see  computer use and pt  satisfaction  jamainternmed2015  in dropbox, or doi:10.1001/jamainternmed. 2015.6186.). this was an observational study done from Nov 2011 to Nov 2013 in an academic safety-net public hospital in San Francisco. details: --47  patients  (mean age 56.5, 55% women, 57% Hispanic/17% African-American/15% Asian/6% white, 55% primary Spanish speakers, 54% with high school education or less, 30% with inadequate health literacy as determined by their ability to fill out medical forms), and 39 clinicians (mean age 43.7, 64% women, 72% in primary care, 72% MDs, mean 13.9 years since getting professional degree) --provider- patient   relationship was <1 year in 16%, 1-5 years in 54% and >5 years in 30%. --mean visit length was 24.6 minu...