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ED Docs Spend More Time With EMRs Than Patients

Emergency department doctors spend substantially more time entering data into EMRs than they do interacting with patients, according to an American Journal of Emergency Medicine study reported by FierceEMR.

According to FierceEMR, the study found that the average percentage of time ED docs spend on data entry was 43 percent. During a 10-hour shift, researchers concluded, total mouse clicks neared 4,000.

In contrast, the amount of time emergency department doctors spent interacting directly with patients during the AJEM study was 28 percent, the researchers found.  Meanwhile, reviewing tests and records accounted for an average of 12 percent of the doctors’ time, and talking to colleagues consumed 13 percent.

It’s hardly surprising that doctors would rack up nearly 4,000 clicks during a shift. Mouse clicks for common charting functions and patient encounters range from a low of six clicks for ordering an aspirin to a high of 227 for completing a record for patients with abdominal pain through the point of discharge, according to an article in Medscape Medical News cited by FierceEMR.

These results are consistent with those of a similar study published earlier this year in the Journal of General Internal MedicineiHealthBeat reports. According to iHealthBeat‘s story,  researchers who observed 29 medical interns at Johns Hopkins Hospital in the University of Maryland Medical College found that the interns spent 40 percent of their time on computer related tasks, and 12 percent of the time talking with and examining patients.

Such reliance on EMRs in the ED may have some benefits, but there are also risks involved,  according to a recent study appearing in the Annals of Emergency Medicine. According to the study, the design of EMRs for emergency departments varies widely, with some having problems which can compromise clinician workflow, communication and ultimately, quality and safety of care.

The Annals research suggests that hospitals ought to be auditing the performance of their EDISs regularly,  given how central these tools are to emergency medicine these days.  If doctors are going to click nearly 4,000 times during a single shift, it’s best if the EDIS in question doesn’t foster communication failures, alert fatigue or wrong order/wrong patient mistakes, all problems which emerge when the EDIS doesn’t function well, researchers concluded.

October 2, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

NY RHIO Brings EMRs To Ambulances

Even with a well-connected RHIO in place, and a healthy EMR on site, most hospitals have to content with paper records when ambulances pull up to their door. But in Rochester, they’ve changed things up.

The Rochester Regional RHIO has partnered with area EMS agencies to put technology in place allowing EMS workers to securely share data with EDs or primary care doctors, reports the Rochester Democrat and Chronicle.

The RHIO itself seems to be a hit — 850,000 people, or half of the Rochester-area population, have agreed to have their records shared with authorized medical providers, the paper notes. It embraces 40 healthcare organizations in the 13-county greater Rochester area, providing links to hospitals, reference labs, radiology practices, eldercare agencies and health plans along with the ambulance teams.

To communicate patient information, the EMS workers create an “electronic pre-hospital care document” which can be uploaded to the patient’s medical record (even if the patient declines to go to the hospital). The ePCD technology is available to EMS crews for no cost.

While there’s scattered use of this approach, mobile EMR connections for EMS workers are unusual, as far as I can tell. But with mobile healthcare apps and EMR front ends growing more sophisticated every day, the time is coming soon when anyone who touches the healthcare process in any way, including EMS personnel, will have a wirelessly-enabled tablet loaded with the software they need to report on the patient.

Frankly, I’m surprised all EMS techs don’t have such a tool already. It just makes too much sense.

February 20, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.