gettyimages 1649622 Veterans Affairs declares war on paperwork

Doctors prepare paperwork in the physician consultation area of the emergency room at Coney Island Hospital. (Photo by Mario Tama/Getty Images)

By Jonathan Kaupanger

I’ve tried to come up with a better way of saying this, but I can’t, so let me apologize in advance if I offend anyone’s sensitivities.

Paperwork sucks!

Imagine if you’re a physician though. In 2016, NEJM Journal Watch conducted a survey on about 60 doctors in 16 different practices during office hours. In total, they had 430 hours of observation. A massive 49 percent of the doctors’ time was spent on electronic health records or desk work and only 27 percent of their time with patients. That’s 210.7 hours on paperwork and only 116 spent with the actual patient!

It’s not just the doctors either. For every hour of care in the emergency room, there’s an hour’s worth of paperwork to be done. Every hour spent in surgery or inpatient acute care means there’s an additional 36 minutes of paperwork. An hour of skilled nursing care results in half an hour of paperwork. Home health care for an hour means there’s 48 minutes of paperwork afterwards.

The VA has said enough is enough, and is making changes to its inbox notification system so the VA’s physicians can spend more time with their actual patients. The inbox notification system was supposed to be just for important clinical information, but has become bogged down with non-urgent and unimportant information.

“The public never sees the excessive amount of emails and alerts that take up a doctor’s time,” said VA Secretary David J. Shulkin, who’s a doctor himself. “Some of it is necessary, but other emails do nothing to advance patient care and can, in fact, pose a major safety hazard because of lesser important emails. We want our doctors to have the right information they need to provide quality health care to veterans, and this is a step in the right direction.”

Now, the VA’s system has been changed to decrease the volume of low-value emails and has trained clinicians to process their inbox in a better way. Early results show that the system is working. VA clinicians now spend 90 minutes less per week on emails. And that means there’s more time to spend on veterans.

“When we let doctors do what they do best – giving care to veterans – we know it improves the care they receive,” Shulkin said.

Connect: @JonathanVets1 |

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