Physicians split time between face-to-face visits, desktop medicine

A study published in Health Affairs, analyzing how physicians spend their time during office visits through time stamps on electronic health records (EHRs), found physicians spend equal time seeing patients and engaging in desktop medicine.

By analyzing how physicians spend their time, researchers wanted to gauge how to improve the current delivery of healthcare. Some physicians have said the implementation of EHRs takes time away from patients, this study hoped to provide analysis on the exact amount of time with patients versus time spent on desktop medicine, which includes communication via patient portals, online requests for prescription refills, ordering tests and reviewing results.

The study included time data from over 31 million EHR entries from 2011 to 2014 by 471 primary care physicians and 765,129 patients. Results showed that physicians spent an average of 3.08 hours on office visits and 3.17 hours on desktop medicine daily. The study found a slight decline in office visit time and an increase in time spent on desktop medicine as the study progressed.

“The logs suggest that physicians allocate equal amounts of their clinically active time to desktop medicine work and to face-to-face ambulatory care visits,” wrote first author Ming Tai-Seale PhD, MPH, associate director at the Palo Alto Medical Foundation Research Institute and consulting professor at Stanford, and colleagues. “While working on progress notes could be considered pre- or post-service efforts, desktop medicine activities not linked to a face-to-face visit are not reimbursable under typical fee-for-service contractual and regulatory arrangements. Many of those activities—such as care coordination and responding to patients’ email—are of high value to the delivery system and to patients, so the staffing, scheduling, and design of primary care practices should reflect this value.”