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The Triple Burden of Administrative Tasks Among US Family Medicine Physicians-A Cross-sectional Study
Meghan Hufstader Gabriel1, Chelsea Richwine2, Robert L Phillips3
1Office of the National Coordinator for Health IT, US Department of Health and Human Services, 330 C Street SW, Washington, DC, 20201, USA. Meghan.Gabriel@hhs.gov.
Background:
Although interoperability advances and policy initiatives have expanded EHR functionality and were intended to streamline clinical workflows, many administrative tasks remain burdensome.
Objective:
To describe the prevalence and co-occurrence of three administrative burdens in family medicine and to assess associations of health information technology (health IT) and organizational resources with these burdens.
Design:
Cross-sectional study PARTICIPANTS: In total, 8419 US family physicians completing American Board of Family Medicine certification requirements in 2024.
Measurements:
Self-reported effort spent tracking down external health information and completing prior authorizations and time spent documenting clinical care outside regular office hours. Key independent variables included perceived EHR support for obtaining external information, ability to complete prior authorizations within the EHR, and use of documentation support tools including scribes, other staff, transcription tools, and EHR templates.
Results:
Respondents were 46% female and 60% under age 50. More than three-quarters of physicians reported at least one substantial administrative burden, and 15% experienced substantial burden from all three activities. Satisfaction with EHR support for obtaining external information was associated with lower likelihood of substantial effort for that task (OR 0.47, P < 0.001), whereas ability to complete prior authorizations within the EHR was not associated with lower prior authorization burden. Use of staff support and EHR templates rated as helpful were associated with lower likelihood of substantial after-hours documentation (staff support OR 0.83, P < 0.001; templates OR 0.70, P < 0.001) and of experiencing the triple burden (templates OR 0.63, P < 0.001).
Limitations:
Cross-sectional, self-reported data from a single physician specialty may limit generalizability.
Conclusion:
Administrative burdens remain common in family medicine. Interoperability and documentation supports may mitigate some burdens, whereas prior authorization burden persists despite current electronic capabilities.
Primary Funding Source:
US Department of Health and Human Services, Office of the National Coordinator for Health IT.
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