EHRs add to paperwork burden for US physicians, study finds

By Emily Rappleye
Becker's Hospital Review, Oct. 27, 2014

EHRs increase time spent on non-patient-related paperwork, a burden that consumes 16.6 percent of the average American physician's working hours, according to a study published last week in the International Journal of Health Services.

The nationwide study was conducted by two New York City internists, Steffie Woolhandler, MD, and David Himmelstein, MD, who co-founded Physicians for a National Health Program and both serve as professors of public health at the City University of New York and lecturers in medicine at Harvard Medical School. Their findings are based on confidential data from the 2008 Health Tracking Physician Survey.

The average physician clocks 8.7 hours of administrative work, which includes billing, insurance approval procurement, financial and personnel management and contract negotiation, according to the study.

"American doctors are drowning in paperwork," Dr. Woolhandler said in a statement.

Based on the study, EHRs are not reducing the load. Physicians using a combination of electronic and paper records spent 18 percent of their time on administrative paperwork, while those using EHRs alone spent 17.2 percent of their time on such tasks. However, physicians using entirely paper records only spent 15.5 percent on bureaucratic tasks.

The authors also found small group practices are more efficient with paperwork than both solo practices and large group practices of 100 or more physicians. Small groups used only 16.3 percent of their time on administrative work, as compared to 19.7 percent in larger groups.

While the paperwork piles up for some, the average physician isn't too overburdened. Physicians clocking up to 20.6 percent of their time on administration were "very unsatisfied," but those close to the national average, who spent 16.1 percent of their time on such work, rated themselves as "very satisfied," according to the study.

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