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Journal of General Internal Medicine

, Volume 34, Issue 7, pp 1096–1097 | Cite as

The Thrill Is Gone: Burdensome Electronic Documentation Takes Its Toll on Physicians’ Time and Attention

  • Mindy E. FlanaganEmail author
  • Laura G. Militello
  • Nicholas A. Rattray
  • Ann H. Cottingham
  • Richard M. Frankel
Concise Research Reports

INTRODUCTION

Exam room computing has become ubiquitous in outpatient clinic visits as electronic health record (EHR) documentation requirements for “meaningful use” are adopted. Despite its initial promise, EHRs have created several unanticipated consequences, not the least of which is that physicians’ attention during patient visits being split between delivering care and completing EHR documentation tasks. Even with real-time documentation in the exam room, the majority of physicians spend additional time after hours completing EHR-related tasks.1 In a recent survey, physicians who reported inadequate time for documentation and “excessive” use of the EHR at home had higher rates of burnout.2

METHODS

We recruited a convenience sample of five Veterans Affairs physicians (four primary care physicians and one specialist) who agreed to participate in Cognitive Task Analysis (CTA) interviews. The interviews consisted of a task diagram, followed by a series of cognitive probes aimed at...

KEY WORDS

electronic medical record ambulatory care physician-patient relations attitude to computers 

Notes

Author Contributions

Zamal Franks conducted two of the interviews but does not meet criteria for authorship.

Funding

VA HRSD funded this work.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

References

  1. 1.
    Sinsky C ; Colligan L ; Li L; et al. Allocation of physician time in ambulatory practice: a time and motion study in four specialties. Ann Intern Med. 2016; 165: 753–760CrossRefGoogle Scholar
  2. 2.
    Olson K, Sinsky C, Rinne ST, et al. Cross-sectional survey of workplace stressors associated with physician burnout measured by the Mini-Z and the Maslach Burnout Inventory. Stress Health. 2018.  https://doi.org/10.1002/smi.2849
  3. 3.
    Militello L, Hutton R. Applied cognitive task analysis (ACTA): a practitioner’s toolkit for understanding cognitive task demands. Ergonomics. 1998;41(11):1618–1641.CrossRefGoogle Scholar
  4. 4.
    Weis JM, Levy PC. Copy, Paste, and Cloned Notes in Electronic Health Records. Chest, 2014, 145(3); 632–638.  https://doi.org/10.1378/chest.13-0886.CrossRefGoogle Scholar
  5. 5.
    Minal R Patel, Jennifer Vichich, Ian Lang, Jessica Lin, Kai Zheng; Developing an evidence base of best practices for integrating computerized systems into the exam room: a systematic review, J Am Med Inform Assoc, Volume 24, Issue e1, 2017, Pages e207–e215,  https://doi.org/10.1093/jamia/ocw121 Google Scholar

Copyright information

© Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2019

Authors and Affiliations

  • Mindy E. Flanagan
    • 1
    Email author
  • Laura G. Militello
    • 2
  • Nicholas A. Rattray
    • 1
    • 3
  • Ann H. Cottingham
    • 4
  • Richard M. Frankel
    • 1
    • 4
  1. 1.VA HSR&D Center for Health Information and CommunicationRoudebush VAMCIndianapolisUSA
  2. 2.Applied Decision Science, LLCCincinnatiUSA
  3. 3.Department of AnthropologyIndiana University-Purdue University IndianapolisIndianapolisUSA
  4. 4.Indiana University School of MedicineIndianapolisUSA

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