How Physicians Spend Their Work Time: an Ecological Momentary Assessment.

Area of Science:

• Medical informatics
• Health services research
• Physician workflow analysis

Background:

• Physician time allocation remains poorly understood.
• Current knowledge gaps exist regarding how physicians utilize their work hours in outpatient settings.

Purpose of the Study:

• To quantify physician time allocation in outpatient care.
• To utilize ecological momentary assessment (EMA) for innovative time measurement.

Main Methods:

• Ecological momentary assessment (EMA) via a smartphone app was employed.
• Data collected from 61 physicians across 28 practices in 16 US states.
• Activities categorized into direct patient care, EHR input, administration, teaching, personal time, and other.

Main Results:

• Physicians spent 66.5% of work time on direct patient care (partially multitasking with EHR).
• Electronic Health Record (EHR) use accounted for 44.9% of total physician time.
• Administrative activities comprised 7.7% of physician work time.

Conclusions:

• Physician efficiency is questionable given limited direct patient care time.
• Electronic Health Record (EHR) systems consume a significant portion of physician work time.
• Redesign of EHRs and physician work processes is recommended.