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.1
Here are 10 ways physicians can lessen the amount of time they spend managing their EHR inbox.
1. Delegate messages when possible. The goal is for you to do only the tasks that require your expertise and to delegate the rest. 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 clinic schedule as opposed to a spot in your personal schedule after work hours.
2. Have your staff fill out forms. They may not be able to complete forms entirely, but they can at least get them started for you.
3. Discuss test results at visits when possible. Create a holding place in your EHR for results that can wait until each patient’s next appointment. This will eliminate the need for messaging between visits.
4. Have protocols for emergent and urgent messages. You can be a little more relaxed with your inbox management if you know that emergent and urgent issues are being handled correctly and will not be missed.
5. Quickly review your inbox before your staff leaves. Look for messages your staff can take care of about 30 minutes before they leave for the day, so you aren’t left dealing with messages that your staff could have handled.
6. Use templates for results. Instead of writing new messages each time for common results, use templates that you can modify as needed.
7. Limit your keystrokes. Talk to your administrative or IT staff about changing the login requirements, for example, to stop requiring a password for every prescription. And leverage your EHR, which may allow you to send common messages to staff with one click.
8. Streamline refills. For most prescriptions you write, check at the current visit to see whether the patient has enough refills to last until the next visit or next physical. This will help you avoid between-visit refill requests. Set up a refill protocol so that staff are authorized to make appropriate refills that you can co-sign. For refills without a protocol, teach staff to fill out requests completely before they get to you with their best educated guess as to how many refills are needed until the next appointment.
9. Remember MACRA starts with MA. Your medical assistant (MA) or nurse can assist with numerous EHR tasks that will help you close care gaps and meet quality performance metrics, which will help you provide more proactive vs. reactive care — make your workday feel less chaotic.
10. Prioritize a reasonable schedule. You may feel that you have no control over your schedule, but you do have some leverage. Advocate for your needs by asking your employer for changes that will make your job more doable and satisfying.
Read the full FPM article: “Practical Ways to Manage Your EHR Inbox.”
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.
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