PCPs, allergy specialists continue to experience high EHR burdens

Key takeaways:

• PCPs spent more time In Basket than allergists, but the number of daily messages stayed relatively consistent before and after the pandemic for both.
• New technologies can help with EHR burden, a researcher said.

WASHINGTON — Primary care providers spent significantly more time with electronic health record documentation vs. allergy and immunology providers — both before and after the COVID-19 pandemic — research showed.

But the number of messages they managed on a given day remained consistent after telemedicine was implemented.

“Throughout our previous publications, we observed that electronic health record documentation burden, clinicians' time spent documenting after hours, and the numbers of In Basket messages have been contributing to clinician burnout,” Sunit Jariwala, MD, a professor in the department of medicine at Albert Einstein College of Medicine, told Healio. “This study specifically sought to assess EHR documentation among allergy and immunology providers,” or AIPs, comparing their use with that of PCPs.

In a small study — presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting — the researchers evaluated the time that AIPs (n = 8) and PCPs (n = 125) at Montefiore Medical Center spent in EHR documentation over three periods:

• August 2019, or pre-pandemic period;
• May 2020, or peak-pandemic period; and
• July 2020, or post-pandemic period.

Jariwala and colleagues found that the mean pre-pandemic daily amount of time AIPs spent with In Basket was around 8.2 (+/– 9.3) minutes compared with 23.4 (+/– 163.3) minutes for PCPs. After the implementation of telemedicine in 2020, the mean daily amount of time AIPs spent in their In Basket decreased to 7.7 (+/– 7.1) minutes, whereas the mean daily amount of time among PCPs was 22.8 (+/– 166.2) minutes.

Meanwhile, the aggregate of messages received per day in the pre-pandemic period was 12.4 (+/– 19.9) and 31.8 (+/– 350.7) for AIPs and PCPs, respectively. In the post-pandemic period, the daily aggregate of messages received rose to 14.4 (+/– 12.5) for AIPs and dropped to 29.8 (+/– 406.2) for PCPs.

“[AIPs] receive a high number of In Basket messages and commonly spend time after working hours answering these messages,” Jariwala said. “In Basket messaging is an area that can be addressed through speech recognition and conversational artificial intelligence-based tools.”

For future research, “we will soon evaluate the impact of innovative technologies on EHR documentation burden (as measured through audit log-based metrics, which we had used in this study),” Jariwala noted.