Saturday, July 29, 2017

Computerized physician order entry: a negative factor in physician productivity and morale


Objectives: To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes.

Methods: All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention) mixed-methods study. One full-time clerical support staff member was trained and hired to enter physician orders in the EHR and conduct previsit planning. Physician satisfaction, productivity, timeliness with EHR documentation, and physician attitudes toward the intervention were measured.

Results: Four months after the intervention, physicians reported improvements in overall quality of life (good quality, 71%–100%), personal balance (43%–71%), and burnout (weekly, 43%–14%; callousness, 14%–0%). Matched for quarter, productivity increased: work relative value unit (wRVU) per session increased by 20.5% (before, April–June 2014; after, April–June 2015; range −9.2% to 27.5%). Physicians reported feeling more supported, more focused on patient care, and less stressed and fatigued after the intervention.

Conclusions: This study supports the use of physician order entry clerical personnel as a simple, cost-effective intervention to improve the work lives of primary care physicians.

This would represent going back to what we had before meaningful use, not a new intervention.

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