Part-Time PCPs Spend Greater Share of Clinic Hours on EHR Than Peers

Part-time primary care physicians (PCPs) spent more time in the EHR per clinic hour than their full-time peers, including more time outside scheduled appointments, according to a cross-sectional study published in JAMA Network Open.

Researchers collected demographic, message, and EHR usage data for University of Wisconsin–Madison (UW) Health PCPs with consistent ambulatory full-time equivalencies (aFTEs) across 11 months (May 2021-March 2022). Each EHR measure was normalized per week and per eight hours of time scheduled with patients.

The study found that panel size, visit volume, or message volume differences did not explain part-time physicians’ additional time spent in the EHR per eight hours of scheduled work time.

However, studies have suggested physicians with lower aFTE may have lower rates of burnout, so more EHR time per eight scheduled hours among lower aFTE physicians may not translate into higher rates of clinician burnout, the authors said. 

While EHR order time was proportional to scheduled clinic hours, inbox time was not. The study authors suggested that since physicians with lower aFTE have more time outside the clinic, they may disproportionately fill it with inbox work.

“Although it sacrifices nonclinical time, more EHR work outside scheduled hours for lower aFTE physicians may allow them to feel caught up or allocate more time for panel management work not afforded to physicians with higher aFTE,” the researchers wrote.

The authors pointed out that their study has limitations, as it was a single-center study with a small sample size (118 physicians). Additionally, the research included administrative EHR use unrelated to patient care that lower aFTE physicians may preferentially do.

“Given the increasing EHR workload and shortage of PCPs in the US, future efforts should find ways to right-size workload for all aFTEs while allowing sufficient time for the inbox, proactive panel management, and quality improvement without affecting personal or nonclinical work time,” the study authors concluded.