Computer Inefficiencies in Primary Care

Goals

To identify the cost of computer inefficiencies in primary care practices in the US, incorporating hours, money , and mortality rates. This should be considered on a physician, practice, and industry level.

Early Findings

  • The New Yorker ran an article about the love-hate relationship doctors have with computers in 2018 and their frustrations about being forced to complete 16 hours of mandatory computer training when the time would have been better spent seeing patients. Three years later, the Epic system they were training for had failed to live up to its name.
  • The author arguing that rather than create efficiencies, the computer system was creating inefficiencies. The article quoted the findings of a 2016 survey that computers had resulted in physicians spending two hours doing computer work to every one hour spent with patients. Half of the time spent with patients was being spent on the computer, which spilled into additional work after hours on the computer.
  • The average day had increased to 11.5 hours for primary physicians due to computer work, which had flowed onto increased burnout rates.
  • One of the reasons for inefficiencies in computer systems is many are designed with users in mind. For example, administration staff have a very different perception of what is needed compared to physicians, so the end product can make things harder rather than easier for different user groups.
  • Within a practice where everyone can add to patient records, doctors complain of the same diagnosis being entered multiple times, which, in effect, renders a feature, such as a problem list redundant. The article argued that written patient notes were short and to the point. In contrast, computer systems encourage doctors to paste in blocks or information like lab results or imaging reports, making notes incomprehensible.
  • However, a counter viewpoint argued the merits, citing the ability to scan patient records to identify patient issues and then develop programs based on need. This creates efficiencies within the practice and means services can be organized to meet demand.
  • Computer software has helped to eliminate wastage in medicine. This has contributed to efficiencies within practices, which have helped improve things like patient wait times. The main reason for this is the reduction in processing times for information.
  • Another efficiency created through computers is improved patient mortality rates as there are fewer errors with patients. With paper records, notes may not always be readily available so treatments were administered without physicians understanding a patients' history , for example. Computer EHR's ensure that all of the information concerning a patient is available and easily accessible.
  • Computers have allowed primary practices to automate a number of mundane tasks and, in doing so, improved productivity and made the practice more cost-effective.

Summary

  • In our initial hour of research, we have explored the relationship between inefficiencies in practice and computer systems or software. Interestingly, some of the inefficiencies were actually caused by the computer systems.
  • It took some time to locate information on the topic, but once we located one source, we were able to leverage it to discover others. Unfortunately, time constraints meant we could not present all of the information found.
  • There is a useful stream of academic research available related to this topic.
  • While we have attempted to focus on primary practice, a lot of the available information is non-descriptive regarding practice type, so some of the information relates to other specialties. We suggest further research as set out below.

Research proposal:

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