Part 1: In-room time
Increasingly, physicians are pressured to see more patients in less time. But quality of care and customer satisfaction must be maintained. The answer to this dilemma is taking care of patients in multiple rooms at the same time, with technicians and orthoptists.
The first part of the study was a manual observation at OHSU using iPad apps. Observers followed physicians, technicians, and orthoptists during their day, and time-stamped what they did when they were in the room with a patient. Three categories looked at were examining the patient, documenting with the EHR, and talking to the patient.
One pediatric ophthalmologist was included in the study, and four other ophthalmologists (a cornea specialist, a glaucoma specialist, a retina specialist, and a general ophthalmologist) were also included for comparison.
The study found that the pediatric ophthalmologist spent an average of 13 minutes with each patient. Of that, 23% of the time was spent pointing and clicking in the EHR; 30% was spent examining the patient, and about 47% was spent talking to the patient’s family members.
For the other ophthalmologists in the study, there was a similar distribution, averaging 10 to 13 minutes per patient—29% of which was spent using the EHR.
From this, researchers noted that physicians do not have much time with each patient, and that while in the room with a patient, nearly 30% of physician time is spent documenting in the EHR.
“The purpose of this study is not to say if this is a good or bad thing for quality of care—I can see it being argued either way,” said Michael F. Chiang, MD, of the Casey Eye Institute at OHSU. “But it’s not much time, and a lot of it is spent on the EHR.”