Primary care physicians spend an average of nearly six hours—more than half of their workday—performing clerical and administrative tasks in their electronic health record systems.

That’s the finding of a retrospective cohort study of 142 family medicine physicians at a large academic healthcare center in southern Wisconsin, conducted by researchers at the University of Wisconsin and the American Medical Association.

The results, published this week in the Annals of Family Medicine, are based on an analysis of EHR event log data collected during a three-year period.

“Clinicians spent 355 minutes (5.9 hours) of an 11.4-hour workday in the EHR per weekday per 1.0 clinical full-time equivalent: 269 minutes (4.5 hours) during clinic hours and 86 minutes (1.4 hours) after clinic hours,” states the study. “Clerical and administrative tasks including documentation, order entry, billing and coding, and system security accounted for nearly one-half of the total EHR time (157 minutes, 44.2 percent). Inbox management accounted for another 85 minutes (23.7 percent).”

According to the authors, the EHR event log data—extracted from an enterprise Epic Systems database—were validated by direct observation as a reliable source of information regarding clinician time allocation.

“Two-thirds of the time on the computer was allocated to clerical and inbox work,” finds the study. In particular, researchers note that “much of a family medicine physician’s workday (84 minutes) is spent on documentation, so it is imperative to find ways to reduce documentation burden.”

Further, in the study, computerized physician order entry accounted for 12.1 percent of clinic hours (43 minutes) in the EHR. “The burden related to order entry has been associated with clinician burnout, dissatisfaction and intent to leave practice,” points out the article. “U.S. physicians spend numerous hours daily interacting with EHR systems, contributing to work-life imbalance, dissatisfaction, high rates of attrition and burnout rates exceeding 50 percent.”

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“This study reveals what many primary care physicians already know—data entry tasks associated with EHR systems are significantly cutting into available time for physicians to engage with patients,” said David Barbe, MD, president of the AMA, in a written statement.

“Unfortunately, clerical and administrative demands are not being reconciled with patient priorities and clinical workflow,” Barbe added. “Poorly designed and implemented EHRs have physicians suffering from a growing sense that they are neglecting their patients and working more outside of clinic hours as they try to keep up with an overload of type-and-click tasks.”

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