“I estimate these changes to your charting work flow will take only five minutes.”
Five minutes is fine if it happens for only one patient. But when it is multiplied by as many as forty patients in a day, the multiples get impressive. Five minutes x forty patients = 200 minutes (more than 1.5 hours a day).
Minor five-minute changes to administrative charting requirements aren’t so minor, especially when you add more time for quality assurance reporting or pay-for-performance initiatives. Suddenly huge swaths of time from a doctor’s opportunity to take care of their patients. We need more care time and less data entry time. Doctors must insist that we not become data entry clerks.
Increasingly, I see the data entry burdens of regulatory health care documentation requirements falling on doctors. On first blush, this seems logical because only doctors (or very capable, highly trained surrogates) understand the nuances required to make potentially life-altering adjustments to the electronic medical record. But when new administrative documentation requirements are added to doctors and other care providers, it compromises our time with patients where we explain the mechanisms of their disease and its management nuances. Discussions of medications, therapies, and required follow-up get get short shrift to mandated governmental documentation burdens. If we want to maintain patient volumes to improve access for new patients, we must get creative. After all, time is not expandable.
And there could be a better way.
I believe we need to get patients more involved in their own care before they see their doctor. Imagine a patient entering proposed changes to their list of health problems, surgeries performed, medications and doses being taken and allergies before they are seen on their cell phone or local waiting-room computer terminal or iPad. These proposed changes could then be reviewed, validated, a approved (or not) by their doctor leaving the majority of the patient visit for what matters: actual patient care.
Then maybe, just maybe, I could salvage four of those five precious minutes for both of us.
Wes Fisher is a cardiologist who blogs at Dr. Wes.
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