There’s been a study that’s been pandered around making the assertion that Physicians lose 48 minutes a day to EHR. This story in Medical Economics is just one example of many. A comment on that story from Dr. Rah describes generally my feelings about the study:
I find it disappointing that such drivel is even reported. #1. A 2012 survey! Data is > 2 yrs old. #2. 411 respondents is a very small N; hardly significant in that there are at least a million users now of EMRs. #3. You can do better–why report such meaningless info??
Of course, this only begins to describe the flaws in this study. First, they were just asking physicians for their perceived views on how long something took with the EHR as opposed to actual time. As humans, we’re really bad at judging the amount of time that’s passed. Not to mention that many of the respondents were trainees who had no history with which to compare. I could go on and on, but I’ll stop there.
I’m not arguing whether EHR saves doctors time or whether it takes more time. I’ve seen places where both sides of the coin have occurred. So, I think that you could write an article that EHR saves doctors time and another article that talks about how EHR takes more time. You can find both experiences out there. There are hundreds of factors at play that influence the answer to this question.
One thing I don’t think anyone would disagree with is that meaningful use has required a lot more time from doctors. So, when you layer on a new EHR with the meaningful use requirements, then you’re probably going to be spending more time documenting in the EHR. Although, is that the EHR’s fault or meaningful use?
It would be nice for someone to do a high quality study on EHRs and the time a doctor spends. However, when you think about the factors that could influence the time spent: EHR software, specialty, location, tech skill of doctor, meaningful use, not meaningful use, etc etc etc, you can see why we haven’t seen a proper study on the impact of EHR on efficiency. There are too many variations for which you’d have to test.
John, I am disappointed in your assessment.
The only people who would not believe this study are administrators, goverment officials, and vendors of EHRs.
Any physician who must currently deal with the current ilk of EHRs and the accomanying ‘Meaningful Use’ mandates will immediately recognize this as truth.
If there had been improvement in EHRs or if regulations had been cut back, then the fact this was from 2012 would have some merit as a criticism. However, as regulations have gotten more Bizantine and EHRs have failed to improve, this study still accurately portrays reality.
I agree with you that the problem is “Meaningful Use” and Govenrment meddling, not the EHR itself. However, Doctors do not get a choice. They must use an EHR as “Meaningfu Use” mandates, thus the two are inextricably linked.
EHRs are document repositories, and as such have utility. “Meaningful Use” has added unnecessary clicks and keystrokes that increase time spent while decreasing efficiency without increasing quality (A combination only the Government could love).
You need to face reality. “Meaningful Use” (It still nauseates me to call it that) as implemented by the current crop of EHR vendors increases time spent by MDs on meaningless mouse clicking and keystrokes, while dcereasing efficiency without improving quality.
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Kevin,
Have you not met any doctors that have become more efficient thanks to EMR even those who have to do MU? I’ve met quite a few. That’s not the reality for many, so I get where you’re coming from, but I think there are both sides of the story.
John
First, No. I have never met a practicing physician that has to do MU with an EHR who saystehy arenow more efficient. BUT I am sure you have and I am sure there are a few out there who would say that. They are known as outliers (If they exist).
In Medicine we say that the plural of anecdote is not data. Suppose you met someone somewhere that said that. That is not data. Data is a survey of hundreds of physicians who tell you what it is really like. That data says this stupidity is costing physicians an average of 48 minutes per day.
Imagine if instead of spending 48 minutes per day clicking boxes that do nothing, that that time was spent caring for patients? Or doing research? Or, god forbid, seeing their family?
I am personally appalled by Government spending $36,000,000,000 of the taxpayers’ money to decrease efficiency, and increase the time Doctors have to spend at work each day, without improving quality. How can you defend this?
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Kevin,
EHR without MU is definitely more efficient than EHR with MU. I believe EHR is more effecient than paper when implemented properly. The challenging one is whether EHR with MU is more efficient than paper. I know some that are and some that aren’t.
That said, this post was about a study that wasn’t very well thought out or done. If it was a well designed study, I’d be more interested in the 48 minutes and what it would mean. Otherwise, it’s as good as a guess.
I agree healthcare would really benefit from a simplification of MU and reimbursement so more good could be done caring for patients rather than clicking boxes.
I’m definitely not defending the $36 billion of MU spending. I’ve asked many times if it was a good use of our money or not and that I believe we’re not getting our money’s worth. However, I will defend the value of EHR and technology’s trans formative effects for good when done well.
Hi John
We can agree that HIT is critical to improving medical care and decreasing cost
I would say EHRs as document repositories that make reports visible anywhere are useful and save some time. But EHRs that require extensive clicking without providing clinical decision support are adding work that is unnecessary.
I think we kind of agree regarding MU that it was a waste of money AND destructive (I am convinced and you are at least skeptical of its utility)
We can agree to disagree on the study in question. I am absolutely convinced regarding the 48 extra minutes per day being true from personal experience and from what my colleagues have routinely stated.
You talk to Docs who are IT geeks (I consider myself among them). Try talking to Docs who practice medicine full time. You will get a more honest assessment of the tremendous waste of time that has been created by MU and by the poor design of many current EHRs. An average of 48 minutes wasted time per day rings very true.