THE PRACTICE OF MEDICINE Electronic Health Record Logs Indicate That Physicians Split Time Evenly Between Seeing Patients And Desktop Medicine

被引:245
作者
Tai-Seale, Ming [1 ]
Olson, Cliff W. [2 ]
Li, Jinnan [1 ]
Chan, Albert S. [3 ]
Morikawa, Criss [4 ]
Durbin, Meg [5 ]
Wang, Wei [6 ]
Luft, Harold S. [1 ]
机构
[1] Palo Alto Med Fdn, Res Inst, Mountain View, CA 94040 USA
[2] Palo Alto Med Fdn, Res Inst, Informat Management Grp, Mountain View, CA USA
[3] Sutter Hlth, Digital Patient Experience, Emeryville, CA USA
[4] Palo Alto Med Fdn, Data & Analyt, Mountain View, CA USA
[5] Canopy Hlth, Emeryville, CA USA
[6] Intuit Inc, Mountain View, CA USA
基金
美国医疗保健研究与质量局;
关键词
PRIMARY-CARE; ALLOCATION; QUESTIONS; MEDICARE; ACCESS; WORK;
D O I
10.1377/hlthaff.2016.0811
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
100404 [儿少卫生与妇幼保健学];
摘要
Time spent by physicians is a key resource in health care delivery. This study used data captured by the access time stamp functionality of an electronic health record (EHR) to examine physician work effort. This is a potentially powerful, yet unobtrusive, way to study physicians' use of time. We used data on physicians' time allocation patterns captured by over thirty-one million EHR transactions in the period 2011-14 recorded by 471 primary care physicians, who collectively worked on 765,129 patients' EHRs. Our results suggest that the physicians logged an average of 3.08 hours on office visits and 3.17 hours on desktop medicine each day. Desktop medicine consists of activities such as communicating with patients through a secure patient portal, responding to patients' online requests for prescription refills or medical advice, ordering tests, sending staff messages, and reviewing test results. Over time, log records from physicians showed a decline in the time allocated to face-to-face visits, accompanied by an increase in time allocated to desktop medicine. Staffing and scheduling in the physician's office, as well as provider payment models for primary care practice, should account for these desktop medicine efforts.
引用
收藏
页码:655 / 662
页数:8
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