A new study revealed that primary care physicians spend a median of 16.1 minutes per day in their electronic health records during paid time off, highlighting challenges in fully disconnecting from work during vacation periods.
In the retrospective cohort study, published in JAMA Network Open, investigators at the Wake Forest University School of Medicine and the American Medical Association analyzed electronic health record (EHR) user action logs from 56 primary care physicians (PCP) working in family or internal medicine clinics between January 2022 and July 2023.
According to the findings, PCPs engaged with EHRs during 39.0% of their vacation days, with 19.0% of paid-time-off (PTO) days involving over 30 minutes of EHR activity. The investigators also found that EHR engagement patterns varied depending on vacation length and the specific day within the vacation period.
"Longer lengths of PTO blocks were associated with decreased EHR engagement," the study authors reported. "Specifically, physicians spent a median of 50.0% (interquartile range [IQR] = 31.0%–75.0%) of short vacation days and 18.0% (IQR = 10.5%–45.0%) of long vacation days with some EHR use," they added.
The investigators observed increased EHR activity at both the beginning and end of vacations. "Physicians spent a median of 57.0% (IQR = 25.0%–77.8%) of first days and 63.5% (IQR = 36.0%–97.2%) of last days in the EHR. In comparison, physicians spent only a median of 29.0% (IQR = 15.5%–54.2%) of middle days in the EHR," the study authors wrote.
Further analysis revealed that approximately 39.5% of total EHR time during PTO was dedicated to inbox-related tasks, suggesting that message management remained a significant workload component even during vacation periods.
Led by Corey Obermiller, MStat, of the Department of Internal Medicine at the Wake Forest University School of Medicine, the investigators classified PTO blocks by duration (short = 2–5 days, medium = 6–10 days, long = > 10 days) and analyzed patterns of EHR engagement across these categories.
The cohort comprised 56 physicians with a mean age of 50.4 years, 58.9% of whom were male. Family medicine physicians constituted 62.5% of the sample, whereas internal medicine physicians represented 37.5%. The study included both community physicians (57.1%) and those with academic responsibilities (42.9%).
"Organizations should implement strategies to minimize clinical tasks during PTO," the study authors underscored. "Future research should explore interventions that help physicians fully disconnect from work," they suggested.
The research built upon previous studies linking EHR use to physician burnout. A national survey cited in the study found that 70.4% of physicians worked during vacation days, and 59.6% reported taking 15 or fewer vacation days in the previous year.
The study was supported by an American Medical Association Electronic Health Record use research grant.
Conflict of interest disclosures are available in the study.