Study finds first-year interns spend 43% of their day working on an EHR

Internal medicine residents devote 87 percent of their work time away from patients, and about half of that is consumed by interacting with electronic health records.

That’s the finding of a new study, conducted by researchers at Penn Medicine and Johns Hopkins University, published on Monday in JAMA Internal Medicine.

The analysis of six internal medicine programs in the mid-Atlantic region assessed how first-year interns allocate time while working on general medicine inpatient services. The researchers documented the activities of 80 interns—which included 194 shifts and 2,173 hours—during a three-month period.

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“Interns are predominantly engaged in indirect patient care, with little variation over 24 hours,” state the authors. “Notably, more than 10 hours (43 percent) of a 24-hour period were spent interacting with the electronic medical record. In contrast, little time was spent in educational activities or direct patient care. When interns were engaged in these activities, indirect patient care often co-occurred.”

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According to the researchers, the study is the largest to examine how young doctors spend their work day.

“This objective look at how interns spend their time during the work day reveals a previously hidden picture of how young physicians are trained, and the reality of medical practice today,” said lead author Krisda Chaiyachati, MD, an assistant professor of Medicine in the University of Pennsylvania’s Perelman School of Medicine. “Our study can help residency program leaders take stock of what their interns are doing and consider whether the time and processes are right for developing the physicians we need tomorrow.”

Chaiyachati and his colleagues conclude that “interns spend substantial time in indirect patient care and little in face-to-face contact with patients or engagement in educational activities.” However, they are not sure whether that is necessarily good or bad.

“Indirect patient care has tradeoffs,” added Chaiyachati. “If it takes time away to the point that patients feel like we aren’t listening to their needs or we lose out on human interactions that provide physicians with a sense of purpose, that is a bad thing. But if it helps us diagnose diseases more efficiently, then maybe that’s not that bad in the end.”

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