One of the most exciting elements of our future healthcare system is the reduction of administrative load, and particularly, documentation burden. It is not difficult to see why: 21% of physicians report spending more than 8 hours per week on the electronic health record (EHR) outside of normal working hours. Rather than relaxing or sleeping during this "pajama time," many physicians are instead curling up with the radiant red aurora of Epic.
It is not just physicians who are impacted by this problem -- patients also have cause to be interested. One large study from Massachusetts General Brigham found that primary care physicians spend a median of 36.2 minutes on the EHR for every 30-minute appointment. A 6.2-minute prolongation may not seem substantial, but over the course of a 16-appointment day, that adds up to nearly 2 hours of delay. And while much of that delay is pushed to pajama time, patients certainly feel the manifestation of this burden in waiting room delay frustration and the sometimes-dissociated conversations of triadic interviewing.
Manual documentation can also make the clinical work itself more difficult. In recent years, "note bloat" has emerged as an oft-cited phrase -- referring to the practice of using dot phrases and copy-pasted templates in notes even when that information is not needed or may be medically incorrect. I saw a patient chart recently that said "prednisone started in March" -- a reasonable statement, yet the "March" in question was that of 2018, and copy-forwarding resulted in incorrect information that changed management.
