Dive Brief:
- Primary care physicians spend a significant amount of time on work in their electronic health records, even when they decrease the number of appointments they schedule with patients, according to new research published in Health Affairs.
- Physicians who cut back appointments saw their visit volume decline by 32.6% compared with other doctors. But their EHR time fell by just 21.2% — meaning the number of minutes spent in their records systems actually increased per visit by more than 20%, according to the study.
- Primary care physicians need to handle a lot of tasks outside appointments, like responding to patient messages, researchers wrote. So reducing visits doesn’t necessarily eliminate a host of EHR tasks — though it does have repercussions for physicians’ pay and patients’ access to care, they noted.
Dive Insight:
Primary care is key to improving patients’ health outcomes and the quality of their care, allowing clinicians to provide preventive services, catch illness early and manage chronic conditions.
But the field is under stress. Primary care physicians are typically paid much less than specialists, contributing to a shortage of providers and increasing wait times for patients.
Meanwhile, clinicians have long criticized a growing burden of administrative work and other tasks in EHRs, which often stretches into after-work hours and contributes to burnout.
However, cutting back on patients’ visits with doctors doesn’t necessarily translate to less time on EHR work, according to the study in Health Affairs.
The research, which analyzed national Epic health record data from 2019 through 2022, found monthly EHR time outside of scheduled hours decreased by just 12.8% for doctors who reduced visit volume. That means EHR time outside of clinic hours per visit increased by nearly 40%.
Not all EHR tasks increased at the same level. For example, time per visit managing electronic messages from patients increased by more than 29% for providers who cut back on appointments. And time per visit on clinical reviews rose nearly 26%, while time spent on notes increased more than 18%.
The disconnect could be linked to several factors, researchers wrote. Physicians could be reducing the number of visits without cutting back the number of patients they care for, so they have to manage an increase in messages from patients who are unable to schedule an appointment.
Doctors could also be choosing to reduce appointments to spend more time on each visit, or they could be cutting back to serve the sickest patients. For example, patient complexity — measured by age and the number of orders and problems listed per visit — rose for physicians who reduced their appointment availability.
Limiting the availability of appointments could worsen wait times for patients, as well as hit primary care providers' pay, researchers noted. Payment models that reimburse doctors for work outside of visits could help, researchers wrote.
Additionally, artificial intelligence tools could assist with EHR tasks. AI scribes, which typically record patients’ conversations with doctors and draft a clinical note, are increasingly prevalent at health systems, while tools to draft messages to patients could also save providers’ time.
