Training time adds minutes to patient encounters
WASHINGTON — The amount of time an attending ophthalmologist spends in a room with a patient is longer when a trainee is present, even when the trainee does not interact with the patient, according to a speaker here.
On average, an attending physician spends 11.5 minutes of face-to-face time in a room with a patient, Michael F. Chiang, MD, told colleagues at the American Association for Pediatric Ophthalmology and Strabismus meeting.
Twenty-nine percent of that time is spent using the electronic health record, 39% is spent examining the patient, and 32% is spent talking, he said.
“That’s not a lot of time, 10 to 13 minutes in Oregon,” Chiang said of the research being done at the Oregon Health and Science University. “The highest is for pediatric ophthalmology, 13 minutes per patient, and about a third of that time is spent using the EHR.”
Using EHR time stamps to figure out “who was where when,” Chiang and colleagues looked at about 7,200 patient encounters at the pediatric ophthalmology service at OHSU over 1 year.
“In Oregon, if we have a trainee who saw that patient, the patient spent 20 extra minutes in the office, and that’s probably intuitive because the resident or fellow adds an extra step in the workflow,” Chiang said. “The interesting thing is that, if there was no trainee who saw that patient but a trainee was present working with that attending, that’s still actually 5 extra minutes per patient, even when the patient was not seen by the resident or fellow.”
Chiang said that the conclusion was not intuitive and theorized that the additional time spent might be from the physical presence of the trainee in the room disrupting workflow or because of extra time taken by the attending physician to educate the trainee. – by Patricia Nale, ELS
Chiang MF. EHRs, big data, and pediatric ophthalmology trainees. Presented at: American Association for Pediatric Ophthalmology and Strabismus meeting; March 18-22, 2018; Washington.
Disclosure: Chiang reports relationships with Clarity Medical Systems, Novartis and Inteleretina.