EHR Use Adds To Administrative Duties

Electronic health records are meant to simplify a physician’s workload, right? Not so, according to an article published in the International Journal of Health Services.

By Katie Wike
Health IT Outcomes, Nov. 5, 2014

Drs. Steffie Woolhandler and David Himmelstein, who serve as professors of public health at the City University of New York and lecturers in medicine at Harvard Medical School, recently studied data from over 4,700 physicians. According to the International Journal of Health Services, this data came from the most recent 2008 Health Tracking Physician Survey.

Woolhandler and Himmelstein found the average doctor spent 8.7 hours per week – 16.6 percent of their working time – on administrative duties. This includes time spent on billing, obtaining insurance approvals, financial and personnel management, and negotiating contracts. It does not include patient related tasks, such as charting, ordering labs, and consulting with other physicians.

Fierce EMR explains Woolhandler and Himmelstein also discovered doctors using electronic health records (EHRs) averaged about 17 percent of their time on administrative duties, while those using paper records spent about 15.5 percent of their time doing the same. For those who used both an EHR and paper records, this number rose to 18 percent. This difference may stem from the fact that EHR documentation often takes longer.

“American doctors are drowning in paperwork,” said lead author Woolhandler. “Our study almost certainly understates physicians’ current administrative burden. Since 2008, when the survey we analyzed was collected, tens of thousands of doctors have moved from small private practices with minimal bureaucracy into giant group practices where bureaucracy is rampant. And under the accountable care organizations favored by insurers, more doctors are facing HMO-type incentives to deny care to their patients, a move that our data shows drives up administrative work.”

iHealth Beat reports the study also found correlations between administrative duties and professional satisfaction. Those who spent more time on such tasks had lower moral. Doctors who reported they were "very satisfied" spent an average of 16.1 percent of their time doing administrative tasks, while doctors who reported being "very dissatisfied" spent 20.6 percent doing such work.

“Our crazy health financing system is demoralizing doctors and wasting vast resources. Turning health care into a business means we spend more and more time on billing, insurance paperwork and the bottom line. We need to move to a simple, nonprofit national health insurance system that lets doctors and hospitals focus on patients, not finances,” said Himmelstein.