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Does More Time on EMRs Mean Higher Efficiency?


    Recent studies published in the Journal of the American Medical Association and Medical Care (JAMA) analyzed timestamp data from electronic medical records (EMRs) to examine how much time U.S. clinicians spend on EMR documentation and how it affects patient care. This concern has been around for years, and it still remains relevant today because of its growing impact not only in patient outcomes, but also in clinician job satisfaction, and overall business operations.

    It was found that U.S. clinicians spend 50% more time on an EMR than those in other countries. According to the JAMA study, in comparison to those in Canada, Northern and Western Europe, the Middle East, and Oceania, clinicians in the U.S. spend an average of 90 minutes a day actively using an EMR, while non-U.S. clinicians only spend about an hour a day. In addition, it was found that US clinicians spend more time using an EMR after work hours. When benchmarked against their global counterparts, the findings have a considerable—and oftentimes compounded—impact on patient care. 


    Implications of EMR time on clinician-patient relationships in home care

    1. Visit overrun

    More time expended on EMRs means lengthier patient visits. This may result in exceeded visit schedules, which can increase patients’ waiting time and overburden clinicians. Time spent is no longer directly proportional to patient needs, which can be problematic in the long run.

    2. Compromising effective patient care

    The more focus is put on EMR documentation, such as notes, orders, in-basket messages, and clinical reviews, the less attention is paid to patient care. While EMRs are an essential part of patient care, the interpersonal engagement between physician and patient should be given higher priority —the very core of the practice.

    3. Clinician burnout

    When documenting medical records becomes a primary task that almost equals personal patient care, burnout may also arise. According to the authors of an opinion piece in the Annals of Internal Medicine published in 2018, “Documentation in other countries tends to be far briefer, containing only essential clinical information. It does not contain much of the compliance and reimbursement documentation that commonly bloats the American clinical note.” This could be one factor as to why U.S. clinicians spend more time on EMRs, which therefore leads to burnout.


    Process improvement opportunities in EMR documentation

    The data can provide useful insights when addressing staff utilization and clinician satisfaction. From the home health business perspective, EMR documentation has a significant role not just in patient outcomes, but also in compliance and reimbursements. It is here to stay whether we like it or not. Ideally, we want to prevent clinician burnout without compromising the thoroughness of the documentation.

    A good way to do this is to capture data and track your clinicians’ documentation practices and trends. Review your EMR documentation process and find opportunities for efficiencies. One solution is to find an outsourcing partner to assist in EMR documentation to ease the load on your clinicians.

    On one hand, clinical review may seem to require extra EMR work for your clinicians, but if used strategically to record documentation trends, establish best practices, and educate clinicians to improve charting accuracy, it can drive significant time-efficiencies in the individual charting work and the entire documentation process.

    The finding suggesting that U.S. clinicians have a greater EMR burden than non-U.S. counterparts is part of a bigger picture that requires long-term systemic solutions. Policy makers and industry leaders should consider this concern when addressing clinician wellness since it creates a domino effect in good patient outcomes and the administrative components.


    Learn more about the JAMA study here>