Tips to help Physicians Prioritize Patients over Paperwork

Tips to help Physicians Prioritize Patients over Paperwork

To improve care, physicians and their team need to focus on improving coordination and communication with patients.

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Ensuring an excellent patient experience is a crucial element in modern medicine. To promote this goal, physicians and their team need to focus on improving coordination and communication with patients. However, administrative tasks—generally referred to as paperwork—are standing in the way of patient care. In fact, in a recent survey by the American Association of Family Physicians (AAFP), administrative burden was the No. 1 task that members asked the Academy to help them with. For instance, electronic medical records (EMRs) have reduced the amount of time physicians can spend to focus on the patient. While medical transcription outsourcing can help with this, adopting certain strategies can help physicians prioritize patients over paperwork.

Studies reveal Impact of EHR Use on Clinical Care A paper published last year in the Annals of Internal Medicine cited several studies which showed the effect of EHR use by physicians on patient care.

According to a time-and-motion study in ambulatory practice across 4 specialties, for every hour a physician spent providing direct clinical care to patients, he/she spent nearly 2 hours on EHR and other desk work, plus another 1 to 2 hours each night. The EHR and desk work included documentation and review, accessing test results, and arranging medication orders.

A 2012 survey of internal medicine physicians showed that the average time spent on EHR documentation was 6.5 hours per week, greater than that spent on paper record systems.

Another study focused on identifying challenges of using EHRs in primary care practices found that costs, lack of knowledge of EHR functions, and problems transforming office operations were barriers to meaningful EHR use. Practices also reported that major disruptions in patient care occurred when systems were being upgraded.

A study that looked into the productivity of emergency physicians using EHRs found that 43% of physician time was spent on data entry and an average of 4000 total mouse clicks for charting functions and documenting patient encounters during a busy 10-hour shift.

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Recommendations on Reducing Administrative Burden In March 2017, the American College of Physicians (ACP) published a set of policy recommendations to put patients first and reduce excessive administrative tasks: 

Stakeholders such as payers, governmental and other oversight organizations, vendors and suppliers who develop or implement administrative tasks should provide financial, time, and quality-of-care impact statements for public review and comment. Tasks that have a negative effect on quality and patient care should be challenged, revised, or removed entirely.

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To minimize the burden of administrative tasks, all stakeholders must regularly review, revise, align, and/or streamline those tasks that cannot be eliminated from the health care system.

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All stakeholders including payers must collaborate with professional societies, frontline clinicians, patients, and EHR vendors to aim for performance measures that minimize unnecessary clinician burden, maximize patient and family centeredness, and integrate the measurement of and reporting on performance with quality improvement and care delivery.

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All key stakeholders should facilitate the elimination, reduction, alignment, and streamlining of administrative tasks by collaborating to make better use of existing health information technologies, as well as develop more innovative approaches.

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With the focus on value-based care, stakeholders should streamline or eliminate duplicative administrative requirements.

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The ACP calls for rigorous research on the effect of administrative tasks on our health care system in terms of quality, time, and cost; clinicians; patient and family experience, and importantly, patient outcomes.

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The ACP also calls for research on best practices to help physicians and other clinicians reduce administrative burden within their practices and organizations.

Simple Strategies to Manage the EHR at the Office Visit In a 2017 Medical Economics article, primary care physicians offered several tips on managing the EHR without compromising the patient encounter:

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Establish eye contact: A 2015 study in the International Journal of Medical Informatics that tracked the eye movements of doctors and patients during exams reported that the patient’s gaze and eye contact followed cues from the physician. The researchers noted that physicians should establish eye contact to create an “inviting, engaging atmosphere” for the patient. Each physician needs to develop a convenient strategy to manage the EHR at the patient visit. For instance, rather than look at the computer, physicians can jot down notes, dictate the narrative portion of the patient exam, and get these documented by a medical transcription company that provides EHR-integrated solutions. This strategy will help the physician better connect with the patient and get vital cues from his/her body language.

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Do prep work before the encounter: One physician said she studies the patient’s data and history before coming to the exam room so that she does not have to refer to the computer for the basic information. Physicians can copy and paste the patient history into the EHR to get a head start on the note before the upcoming encounter.

Using laptops on carts is another strategy that will minimize the intrusiveness of the EHR and allow the physician to focus in the patient. In other words, with good background knowledge, physicians can walk confidently into the encounter knowing what they want to do.

Involve the patient in the EMR: Studies have found that patient satisfaction and patients’ involvement in the decision-making process improves when physicians share information visually from the EHR monitor. Patients can be shown data and charts to understand trend lines for weight, hemoglobin A1C and other types of discrete and trackable data. Excellent educational tools, EHR charts and graphs show the potential of technology for patient-centered care

The primary goal of physicians is to provide their patients with the best care possible, despite administrative tasks or other barriers. When it comes to clinical documentation, outsourcing medical transcription is a viable option to streamline processes, reduce burden, and enhance the patient experience.

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