Richard J. Baron, FACP, (a member of ACP Internist's editorial board) used his electronic health record system to track for one year the uncompensated tasks he and his colleagues perform every day at his five-doctors practice, Greenhouse Internists in Philadelphia.
--Calls averaged of 23.7 per physician per day: 35.7% for an acute problem, 26.0% for prior authorizations or documents for insurers or employers, 6.3% for consultations, 17.5% test results, 9.5% for advice for clinical decisions faced by patients, and 5.0% were for clinical follow-up.
--E-mails averaged 16.8 per day: 59.3% to interpret test results, 21.7% for patient responses, 9.3% for administrative problems, 5.0% for acute problems, 2.8% for proactive outreach to patients, and 1.9% for discussions with consultants.
--Refills averaged 12.1 prescriptions per day, excluding those handled during visits or calls for other issues, but each requiring chart review.
--Laboratory reports averaged 19.5 per day, each requiring a response, analysis and possible medication adjustment.
--Imaging reports averaged 11.1 per day, usually requiring patient communication and work-ups.
--Consultation reports averaged 13.9 per day, with more work required.
Before the EHR, a nurse handled such tasks. The practice implemented its EHR and the nurses' job fell to non-clinical staffers. Now, they have so much information, they hired an RN for "information triage" of lab reports, calls and consultation notes.
Dr. Baron told the Washington Post that he was "stunned" by the numbers he uncovered. How do his compare to your practice? Let us know.