Practical Ways to Manage Your EHR Inbox

 

Physicians are drowning in paperwork, messages, EHR tasks, and other administrative responsibilities. One study found that for every hour physicians spend providing direct clinical face time with patients, they spend nearly two hours on EHR and desk work during the clinic day.1 After clinic, physicians spend one to two hours doing additional computer and other clerical work (dubbed “work after clinic”).1

Systemic changes are needed to help reduce physicians' administrative burden and address “system-induced distress,”2 but in the meantime there are steps physicians can take to reduce the amount of time we spend on these tasks. This article shares 10 practical tips for one of our biggest time wasters — the EHR inbox.

KEY POINTS

  • For every hour physicians spend providing direct patient care, they spend nearly two hours on EHR and desk work within the clinic day, plus one to two hours on additional work after clinic.

  • While system changes are needed to reduce physicians' administrative burden, there are steps physicians can take themselves to lessen the amount of time they spend on these tasks.

  • To address one of the biggest time wasters — the EHR inbox — consider delegating messages, having staff fill out forms, handling test results during visits, reviewing your inbox before staff members leave for the day, as well as other tips.

1. DELEGATE MESSAGES WHEN POSSIBLE

The default in many EHR systems is for all messages to go directly to the physician, but this is inefficient. Ask your IT staff to set up your system so it routes messages to the appropriate person, such as your medical assistant (MA) or nurse, and then have your staff do all they can before getting you involved. The goal is for you to do only the tasks that require your expertise and to delegate the rest.

When your input is needed, teach staff to take in-depth messages so that you will have the information you need to reply effectively. You can make templates for this. For example, “When someone calls with urinary symptoms, ask them to specify duration of symptoms and, if they have dysuria, urinary frequency, fever, back pain in kidney area, or chance of pregnancy.”

If a message involves an issue that will take a lot of time, instruct your staff to schedule the patient for an in-person or telehealth visit. That way, you will get reimbursed for your work and it will take up a spot in your work schedule as opposed to a spot in your personal schedule after work hours.

2. HAVE YOUR STAFF FILL

ABOUT THE AUTHOR

Dr. Winner is a family physician with Sansum Clinic in Santa Barbara, Calif., and runs its stress-reduction classes. He is author of Relaxation on the Run and frequently lectures on health, stress, and physician well-being. He is also an adjunct clinical assistant professor of family medicine at the Keck School of Medicine, University of Southern California.

Author disclosure: no relevant financial affiliations.

© 2021 Jay Winner, MD, FAAFP

References

1. Sinsky C, Colligan L, Li L, et al. Allocation of physician time in ambulatory practice: a time and motion study in four specialties. Ann Intern Med. 2016;165(11):753–760.

2. Winner J, Knight C. Beyond burnout: addressing system-induced distress. Fam Pract Manag. 2019;26(5):4–7.

3. Shanafelt T, Goh J, Sinsky C. The business case for investing in physician well-being. JAMA Intern Med. 2017;177(12):1826–1832.

 
 

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