December 12, 2022
2 min work
Disclosures: Rule reports nary applicable fiscal disclosures. Please spot the survey for each different authors' applicable fiscal disclosures.
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Female superior attraction physicians walk much clip utilizing physics wellness records than antheral PCPs, and this spread has widened implicit time, according to a survey published successful the Journal of General Internal Medicine.
“The gender spread successful EHR use is growing, peculiarly for enactment writing, inbox management, and clip extracurricular scheduled objective hours,” Adam Rule, PhD, an adjunct prof astatine the University of Madison-Wisconsin Information School, and colleagues wrote.
To measure trends successful physics wellness grounds (EHR) usage among PCPs, “who usage EHRs much than physicians successful different specialties,” the researchers collected monthly information from April 2019 to March 2022 from Epic Systems, a backstage wellness attraction bundle company.
Rule and workfellow utilized 5 measures to find gaps successful EHR usage: full EHR time, clip successful notes, clip successful orders, clip successful inbox and clip extracurricular scheduled session hours. These metrics were analyzed done some model-adjusted and unadjusted comparisons.
The investigation included responses from 160 PCPs, 108 of whom were women. All the participants practiced astatine the University of Wisconsin Health world aesculapian halfway during the survey period.
From April 2021 to March 2022, the researchers recovered that pistillate physicians averaged an unadjusted mean full of 7 hours successful full EHR time, compared with 5.3 mean hours for antheral physicians (P < .001).
Female physicians besides spent much clip successful notes (2.5 vs. 1.4 hours; P < .001), clip successful inbox (1.3 vs. 1 hours; P = .001) and clip extracurricular scheduled session hours (3.1 vs. 2 hours; P < .001) compared with their antheral counterparts.
In adjusted comparisons, pistillate physicians had higher means of:
- total EHR clip (1.5 hours; 95% CI, 0.7-2.4);
- total clip successful notes (0.9 hours; 95% CI, 0.5-1.4);
- total clip successful inbox (0.2 hours; 95% CI, 0.1-0.4); and
- total clip extracurricular docket session hours (1.1 hours; 95% CI, 0.4-1.8).
The lone measurement that women did not importantly walk much clip doing successful adjusted and unadjusted analyses was clip successful orders, according to the researchers.
When examining the alteration successful EHR usage implicit time, Rule and colleagues reported that from 2019 to 2021, the spread accrued by:
- 8.3 minutes a twelvemonth for full EHR clip (95% CI, 4.6-11.9);
- 6.1 minutes a twelvemonth for clip successful notes (95% CI, 4.1-8);
- 3.3 minutes a twelvemonth for clip successful inbox (95% CI, 2.2-4.4); and
- 6.6 minutes a twelvemonth for clip extracurricular scheduled session hours (95% CI, 2.7-9.6).
The researchers noted that the disparities successful EHR usage are larger than those reported successful erstwhile studies, a improvement which “may beryllium owed to differences successful wellness systems, clip periods, oregon specialties observed,” they wrote.
Rule and colleagues besides expressed interest implicit the spread successful clip extracurricular scheduled session hours fixed the links betwixt burnout and outside-hours EHR usage. A 2017 survey successful the Journal of Graduate Medical Education recovered that 75% of PCPs attributed burnout to EHR time, and those who spent much than 6 hours play successful EHR clip were 2.9 times much apt to study burnout.
“It is captious that wellness systems research basal causes down these differences and make solutions to code them considering the higher burnout among pistillate physicians,” Rule and colleagues wrote.
The researchers projected respective imaginable solutions, including further documentation and inbox support, reduced diligent interaction and a reduced sheet size. They concluded that aboriginal probe should further analyse EHR sex gaps successful different domains “and the interaction of targeted interventions to trim EHR load for pistillate physicians.”
References:
- Robertson S, et al. J Grad Med Educ. 2017;doi:10.4300/JGME-D-16-00123.1.
- Rule A, et al. J Gen Intern Med. 2022;doi:10.1007/s11606-022-07837-2.
Perspective
This survey from Rule and colleagues adds grounds confirming that women superior attraction physicians person an accrued magnitude of enactment done successful the EHR compared with men PCPs.
Over time, the EHR has go a larger stock of physicians’ workload — physicians present walk overmuch of their days responding to diligent messages and calls, reviewing laboratory and imaging results, ordering tests, penning notes and clicking done reminders and notifications.
One uncovering of this study, which is peculiarly important, is the ample sex quality Rule colleagues documented successful WOW (work extracurricular of work), meaning the clip spent successful the EHR extracurricular of scheduled objective hours. We cognize that women physicians person higher burnout rates than bash men physicians. This survey illuminates 1 of the factors contributing to women’s higher burnout rates: you tin ideate that if enactment bleeds implicit into evenings and weekends, into the clip that could different beryllium spent successful activities that boost well-being, past determination volition beryllium consequences successful the likelihood and severity of burnout.
This survey — similar the 1 that we conducted astatine Brigham and Women’s Hospital successful Boston — showed that women PCPs spent much clip moving successful notes and the inbox, but not successful orders. This signifier suggests that the sex quality successful EHR clip is not owed to differences successful accomplishment oregon ratio astatine utilizing the EHR. Thus, the findings connote that efforts to manager physicians successful businesslike EHR usage volition not lick the sex spread successful enactment time. Our survey documented an accrued measurement of messages from some patients and unit to women PCPs — this accrued workload is simply a basal origin of sex differences successful EHR enactment hours. Thus, strategies to code the higher fig of hours that women physicians walk successful the EHR indispensable absorption connected the influx of messages they face.
Reference:
Rittenberg E, et al. J Gen Intern Med. 2022;doi: 10.1007/s11606-021-07298-z.
Eve Rittenberg, MD
Primary attraction physician, Brigham and Womens Fish Center for Womens HealthAssistant prof of medicine, Harvard Medical School
Disclosures: Rittenberg reports nary applicable fiscal disclosures.
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