Electronic health records, pyjama time and date night

According to a recent Clinical Psychiatry News article it seems physicians are beginning to call Electronic health record (HER) "Pajama time.” That’s the few hours physicians are spending every night finishing up their documentation, clearing out their in-box,”

University of Wisconsin researchers studying the impact of EHR systems on physicians’ workflow and lives looked at how often and when doctors were accessing their patients’ medical records. They found what many might think is obvious - doctors don’t have enough time in their days to finish their documentation, so they spend their evenings and weekends finishing up.

There is even a thing called “date night” which correlates with data showing this type of work being undertaken on Saturday nights. The same study “found that primary care physicians were spending 38 hours a month after hours doing data entry work.

At a session held in conjunction with the annual meeting of the Healthcare Information and Management Systems Society, Dr. Sinsky spoke about how electronic health records have not lived up to their promise of helping streamline patient care and instead have added hours and headaches to most physicians’ days. Here are a few of the reasons for this additional work.

1. It takes 33 clicks to order and record a flu shot. And in the emergency room, it takes 4,000 clicks to get through the day for a 10-hour shift.” Studies have shown that physicians are spending 44% of their day doing data entry work, [but] 28% of the day with their patient.”

2. Today’s EHRs have a workflow that doesn’t match how clinicians work.  Many clinicians are encountering these very rigid workflows that don’t meet the patient’s need and don’t meet the provider’s need.

3. Most EHRs lack a place for a photo of the patient and his or her family, and a place for the patient’s story, a deficiency that detracts from the value of the encounter.

4. Often, both a physician and a nurse or medical assistant need to add documentation to the EHR. Yet many systems are set up such that each party must log in, then log out, before another can contribute.