Docs spend more than an hour a day on EHR-based notifications

Physicians spend more than an hour a day dealing with the notifications they receive from their electronic health records, according to a new study in JAMA Internal Medicine.

Physicians receive many kinds of electronic notifications, such as test results, requests for medication refills and messages from other providers. The researchers, from the Houston Veterans' Affairs Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey Veterans' Affairs Medical Center, wanted to quantify the number of notifications and corresponding burdens on physicians. They analyzed the electronic logs of notifications by 92 physicians in three large Texas practices from Jan. 1, 2015, to June 30, 2015.

They found that primary care physicians received a whopping mean of 76.9 notifications a day, of which 20.2 percent were related to test results. Specialists had less of a burden, receiving 29.1 total notifications a day, of which 10.4 related to test results. However, since a single notification often contains multiple data points, the actual burden and cognitive effort to handle them is likely greater, the authors said.

Extrapolating the information, the results suggest that physicians spend about 66.8 minutes a day processing the notifications.  

"Information overload is of emerging concern because new types of notifications and FYI [For Your Information] messages can be easily created in the EHR," the researchers said. "Furthermore, the additional workload to read and process these messages remains uncompensated in an environment of reduced reimbursements for office-based care."

The authors urged the development of strategies to filter messages, EHR design to support a more team-based approach and the adoption of staff models to help physicians manage their time.

Other studies corroborate that multiple, intrusive and/or clinically unnecessary EHR alerts contribute to information overload and can cause clinicians to overlook important test results. Customizing notifications and clinical decision support can help alleviate this problem.

To learn more:
- here's the study

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