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Given our concern for provider wellness, we appreciate the contribution by Arndt et al. We also wanted to briefly contribute our experience as it differs significantly, and we believe it offers hope that things can be better.
As participants in the AMA’s Joy in Medicine program we have been calculating EHR time-based measures for the last 2 years (indexed to 8 hrs of scheduled appointments). It was also helpful to compare our indexed EHR time measures and Inbox volume to the authors’ findings to compare Primary Care practice patterns. In 2023 our EHR(8) time was 326 min, (65 minutes/17% less than Arndt et al). Our Work Outside of Work (WOW(8)= time outside of scheduled hours + time on unscheduled days) was 54 min (112 minutes/67% less than Arndt et al). Our Inbox volumes were also significantly less for Patient Calls (6.2 vs. 23.5 per 8 hours scheduled time) and Patient Medical Advice Requests (5.7 vs. 15.3 per 8 hours scheduled time).
During the last 2 years our time-based EHR measures have improved, contrary to the experience reported by Arndt et al. We have seen a decrease in total EHR(8) time of 34 min and Work Outside of Work (WOW(8)) of 16 min for our Primary Care group consisting of physicians and APP’s in Family Medicine, Internal Medicine, and Pediatrics.
While we appreciate that there is likely some variation between practice settings, we feel it is important to highlight that it is indeed possible to provide high-quality primary care with much less provider EHR time and Inbox burden than reported by Arndt et al. We are grateful to our wonderful support staff, our EHR educators, and our team-based care approach. We are actively focused on measuring time and task volume for the entire care team for ongoing improvement for all EHR users.