In a new study funded by the American Medical Association identifying top specialties stuck in electronic health records (EHRs), authors found regardless of specialty, physicians frequently spend more than half their clinical time doing documenting, reviewing, ordering, and managing their inbox.
The study, published in the Journal of General Internal Medicine July 28, found that on average, physicians across all specialties spend 3.4 hours in the EHR – or 57.8% of their total clinical time – and another 1.2 hours outside of work hours, both on days with scheduled appointments and days without.
Using data from a sample of more than 200,000 physicians, the new study showed that specialties whose physicians had the highest amount of overall EHR time compared to eight hours of scheduled patient time were:
- Infectious disease, whose physicians spent 8.4 hours on their EHRs;
- Endocrinology, with 7.7 hours of EHR work;
- Primary care (family and internal medicine) with 7.3 hours; and
Meanwhile, specialties whose physicians spent the least amount of time in the EHR were:
- Anesthesiology, with 2.5 hours per eight hours of scheduled patient time;
- Orthopaedics with 3.3 hours within the EHR;
- Otorhinolaryngology and surgery, each spending 4 hours; and
- Dermatology with 4.3 hours of EHR work.
Physicians are regularly pressed to manage an overcrowded EHR, including clogged inboxes bursting with prescription refill requests, appointment reminders, and other online communications, leading to heavy workloads and stress associated with physician burnout.
The Texas Medical Association recently took steps to address EHR burnout during the association’s annual TexMed conference in May. During the event, TMA’s House of Delegates adopted a joint report – brought forth from the Council on Socioeconomic and the Committee on Health Information Technology in response to Resolution 412 (2023) – that sought pathways for physicians to get paid for time spent on managing their inbox.
The study, conducted between November 2021 and April 2022, used Epic Systems’ Signal platform to track mouse activity or keystrokes in physicians’ EHRs. The data was used to measure physician activity in four primary functions: documentation, chart review, orders and inbox management.
According to the study, documentation accounted for most of physician’s EHR time, requiring 2.3 hours for every eight hours of patient care. Chart review, ordering functions – processes used to implement patient care, such as managing prescription requests, imaging studies, and other services – and inbox also required significant amounts of time, necessitating 1.1 hours and 0.8 hours, respectively.
Although research noted wide variation among specialties, it found all ambulatory care physicians spend a substantial amount of time working in their EHR, averaging 5.8 hours per eight hours of time scheduled for patient care.
For more strategic tips on how to manage inbox messages, among other EHR responsibilities, visit TMA’s webpage on electronic health records. AMA’s inbox-reduction checklist as part of its STEPS Forward campaign also offers best practices to fight EHR overload.
Alisa Pierce
Reporter, Division of Communications and Marketing
(512) 370-1469