Team-based EHR documentation cuts physician EHR time

Physicians who adopted team-based documentation experienced increased visit volume and reduced EHR documentation time, according to a study published in JAMA Internal Medicine.

The national longitudinal cohort study analyzed weekly EHR metadata from September 2020 through April 2021.

Of 18,265 physicians included in the study, 1,024 physicians adopted team-based documentation support. Team-based documentation approaches include traditional in-person scribes, virtual scribes, or note co-authorship with nonphysician clinician members of the care team.

Physicians who adopted these approaches experienced a 6.0% increase in weekly visit volume and a 9.1% decrease in documentation time.

The benefits of team-based documentation support were even more substantial as time progressed. After 20 weeks, visits per week increased by 10.8% and documentation time decreased by 16.2%.

The authors suggested that this period allowed adopter physicians and their teams to refine collaborative workflows and become more familiar with team-based clinical documentation.

However, the study found that only high-intensity adopters (physicians with greater than 40% of note text authored by others) saw reductions in documentation time.

For high-intensity adopters, the researchers found a 21% decrease in time spent writing notes (approximately an hour less time spent documenting per week) and a 10% decrease in EHR time outside scheduled hours.

Low adopters of team-based clinical documentation experienced no meaningful change in EHR time but saw a similar increase in visit volume.

The study authors suggested that low adoption might indicate incomplete training, a lack of organizational support or other program imperfections.

"Operational tracking of the share of note text authored by others could be useful for identifying and addressing implementation challenges that have limited the use of collaborative documentation and are inhibiting the full realization of the benefits," the researchers wrote.

Hannah Nelson has been covering news related to health information technology and health data interoperability since 2020.