Have you ever wondered why the background music at a doctor's appointment is as often the clicking of computer keys as it is the sound of people saying “ahhhh” or asking for health advice? Doctors are asking the same thing.
Physicians have always written clinical notes, but the increased time spent documenting billing details for insurance companies has become a major cause of job dissatisfaction and burnout. A new study led by researchers at the University of Maryland School of Public Health and published Monday in JAMA Internal Medicine suggests that collaborating on clinical notes with other team members can help doctors and other healthcare professionals spend more time treating patients without losing important information.
“Healthcare workers are already overstretched and under immense pressure to see more patients and record more information,” said Nate Apathy, assistant professor in the Department of Health Policy and Management, “so we asked ourselves whether we could ease that burden by using medical records clerks and other teamwork to help with documentation.”
Apathy conducted the study with collaborators at the University of California, San Francisco and the University of Minnesota. Their longitudinal study looked at the documentation practices and weekly visit volume of more than 18,000 outpatient physicians (mostly primary care physicians and some medical and surgical specialists) from more than 300 U.S. practices over a nine-month period. Of these physicians, 1,024 employed some form of teamwork in their clinical documentation.
“We learned that it's not just the teamwork around documentation that's important, but how much work the non-physician collaborators put in,” Apathy said.
All providers who used transcribers or other forms of document collaboration were able to increase the number of patient visits per week, but only those whose teams wrote at least 40% of the note content actually reduced physician note-writing time.
On average, visits increased by 6% and documentation time decreased by 9.1%. After the 20-week learning period, visits increased by 10.8% and documentation time decreased by 16.2%. For those with heavy adoption (those who had others write 40% or more of their notes), weekly documentation time decreased by over an hour (a 28.1% decrease), a relatively large time savings.
“Our research shows that when physicians use teamwork to create their notes, whether that's collaborating with an in-room scribe, a virtual note-taking service, or collaborative note-taking with other clinical team members in the office, they see more patients and, best of all, spend significantly less time glued to their computers,” Apathy said.
