Nearly one-third of the physicians’ working time on the computer is spent on documentation and searching for patient information
Anni Männil, a Health Hare Technology MSc student at Tallinn University of Technology, analyzed Estonian family physicians’ time utilisation during physician-patient visits. The results of the study show that physicians spend almost half of their working time on the computer, out of which the most time-consuming activities are data entry and patient information queries.
The study was carried out as an observation at 63 direct patient appointment sessions with seven family physicians. The observations revealed that physicians spent a mean of 37% of the visit time on computer-based activities and 63% on non-computer tasks, the most time-consuming activities during the face-to-face visit being counselling/teaching, taking anamnesis, documentation and searching patient's medical history from the Electronic Health Record (EHR)/Electronic Medical Record (EMR).
The results of the observational study showed that the vast majority of the computer time is spent on just a few activities — data entry and queries — indicating the inefficiency of the existing process or lack of sufficient support for these time-consuming activities. Männil explains that this in turn increases the physician’s workload, causes stress and can lead to burnout. The physicians stated that documentation is too time consuming mostly because the EMR does not fully support fast and efficient performance of their work processes — unstructured data, lack of necessary notifications, and non-user friendly UI were a few of the bottlenecks brought out by the physicians.
Although all of the family physicians saw the positive merits of the EMR and other e-solutions they are using, more than half of them thought that documentation, data entry and other bureaucratic activities take up too much of their working time, both during the visits and in general. “The only facilitating function brought out was a feature called “typical”, which allows the physician to save prepared and unfilled text into the EMR that can then be copy-pasted to a patient’s medical record. Although it saves the physician’s documentation time and improves the quality of treatment as all the needed information is pre-written in the text, the documentation process is still not fast and convenient enough,” described Männil.
While six out of seven physicians found that they feel they have enough direct contact with the patient throughout face-to-face sessions, more than half of them admitted that using a computer during the visit influences their communication with the patient in a rather negative way. Moreover, burdensome activities affect the well-being of physicians by impacting their mental and physical health, causing anxiety, depression, burnout, and physical inactivity due to fatigue and lack of time. In order to reduce and prevent stress, overload and time waste, physicians’ workflow needs to be transformed so that the e-solutions used, support their work as much as possible.
According to Männil information regarding the physicians’ time utilisation is highly important as it helps to identify and address potential inefficiencies in their daily work, as well as study the effects of newly implemented solutions, and therefore help reduce physician’s cognitive load, stress and burnout, save time and reduce costs for the healthcare funders and primary care providers, give an opportunity for software developers to create innovative problem-solving solutions and services tailored exactly to the needs of family physicians.
Read the full version of the master's thesis HERE.
Health Care Technology (HCT) is a unique Master’s programme in Europe that provides interdisciplinary knowledge on digital technologies, innovation and change management of health care. It relies on the best practices of health care digital transformation and e-health innovations from Estonian e-health system and international successes.
