How Big Data Is Raising Costs And Killing Doctors

This week, I interviewed two doctors starting a new practice in Little Rock using the Direct Primary Care model. We talked a good bit about a number of issues, but particularly, those of Electronic Medical Records (EMR), their distribution, and security. It came up that their days as employees of the University of Arkansas for Medical Sciences went something like this:

• 8:00 AM to 12:00 PM: see patients (with fit-ins possibly pushing that back to 1:00 PM)
• Lunch
• 1:00-2:00 PM to 6:00 PM: paperwork (ICD-10 coding, mainly)

That is to say, they were expensive secretaries whose time was better spent doing other things. Doctors are scarce as it is, and this makes a bad situation worse. It also meant that these two young women were unable to pick up their children from daycare, even given a ten-hour window! It is all too sadly typical:

A recent study in the Annals of Family Medicine used the E.M.R. to examine the work of 142 family medicine physicians over three years. These doctors spent more than half of their time — six hours of their average 11-hour day — on the E.M.R., of which nearly an hour and a half took place after the clinic closed.

Another study, in Health Affairs, tracked the activities of 471 primary care doctors over a three-year period, and also found that E.M.R. time edged out face-to-face time with patients.

This study came on the heels of another analysis, in the Annals of Internal Medicine, in which 57 physicians were observed directly for 430 hours. The researchers found that doctors spent nearly twice as much time doing administrative work as actually seeing patients: 49 percent of their time, versus 27 percent.

The insanity of such paperwork loads is obvious, and contributes mightily to physician burnout. According to a study from the Mayo Clinic, 1 in 5 doctors plan to curtail their clinical hours over the next two years, and 1 in 50 plan on leaving the field altogether. Big Data comes with real-world consequences. Remember that the next time you see some self-interested company pitching its wares as a means to improve outcomes or costs,  or some dimwit politicians endorsing it using fatuous acronyms.