Tethered to the EHR: A Physician Workload Assessment

Article for Discussion

Arndt BG, Beasley JW, Watkinson MD, et al. Tethered to the EHR: primary care physician workload assessment using EHR event log data and time-motion observations. Ann Fam Med. 2017; 15( 5): 419– 426.OpenUrlAbstract/FREE Full Text

Discussion Tips

With advancements in medicine have come an increased demand for non-face-to-face patient care and administrative tasks for primary care physicians. This study retrospectively assessed how many hours primary care physicians dedicate to their work, with a focus on increased time spent on electronic health records (EHR). The article provides an opportunity to discuss expectations of physicians and the direct effects on physician burnout, professional satisfaction, and direct patient care.

Discussion Questions

• What question is asked by this study and why does it matter?

• How does this study advance beyond previous research on this topi?

• How strong is the study design for answering the question?

• What are the main study findings?

• To what degree can the findings be accounted for by:

  • ○ How physicians were selected for the study?

  • ○ The type of practice of the physicians in the study?

  • ○ How the main variables were measured?

  • ○ How the findings were interpreted?

• How comparable is the study sample to physicians in your practice? What is your judgment about the transportability of the findings?

• What contextual factors are important for interpreting the findings?

• How might this study change your practice? Policy? Education? Research? System level intervention?

• Who are the constituencies for the findings, and how might they be engaged in interpreting or using the findings?

• What are the implications for:

  • ○ Design of the EHR

  • ○ Staffing of family medicine offices (see the article by Gidwani et al in this issue, on the use of scribes)²

  • ○ Scheduling patients

  • ○ The future of family medicine?

• What researchable questions remain?