How Physicians Spend Their Work Time: an Ecological Momentary Assessment

被引:15
|
作者
Toscano, Fabrizio [1 ,2 ,3 ,4 ]
O'Donnell, Eloise [1 ]
Broderick, Joan E. [5 ]
May, Marcella [5 ]
Tucker, Pippa [5 ]
Unruh, Mark A. [1 ]
Messina, Gabriele [2 ]
Casalino, Lawrence P. [1 ]
机构
[1] Weill Cornell Med, Dept Populat Hlth Sci, New York, NY USA
[2] Univ Siena, Dept Mol & Dev Med, Siena, Italy
[3] Albert Einstein Coll Med, Dept Med, Bronx, NY 10467 USA
[4] Montefiore Med Ctr, 111 E 210th St, Bronx, NY 10467 USA
[5] Univ Southern Calif, Ctr Social & Econ Res, Los Angeles, CA 90007 USA
关键词
physicians time; electronic medical records; ELECTRONIC HEALTH RECORDS; PRIMARY-CARE; MOTION; US;
D O I
10.1007/s11606-020-06087-4
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background Little is known about how physicians spend their work time. Objective To determine how physicians in outpatient care spend their time at work, using an innovative method: ecological momentary assessment (EMA). Design Physician activity was measured via EMA, using a smartphone app. Participants Twenty-eight practices across 16 US states. Sixty-one physicians: general internal medicine, family medicine, non-interventional cardiology, orthopedics. Main Measures Proportions of time spent on 14 activities within 6 broad categories of work: direct patient care (including both face-to-face care and other patient care-related activities), electronic health record (EHR) input, administration, teaching/supervising, personal time, and other. Key Results After excluding personal time, physicians spent 66.5% of their time on direct patient care (23.6% multitasking with use of the EHR and 42.9% without the EHR), 20.7% on EHR input alone, 7.7% on administrative activities, and 5.0% on other activities (0.6% using the EHR). In total, physicians spent 44.9% of their time on the EHR. Limitations Unable to measure time spent at home on the EHR or other work tasks; participating physicians were not a random sample of US physicians. Conclusions The efficiency of highly trained professionals spending only two-thirds of their time on direct patient care may be questioned. EHR use continues to account for a large proportion of physician time. Further attempts should be made to redesign both EHRs and physician work processes.
引用
收藏
页码:3166 / 3172
页数:7
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