MedicalResearch.com Interview with:
David Ouyang MD
Department of Internal Medicine
Stanford University School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Ouyang: In American teaching hospitals, trainee resident physicians are an integral part of the medical team in performing procedures, writing notes, and coordinating care. As more care is being facilitated by electronic medical record (EMR) systems, we are just now finally able to understand how much residents work and how residents spend their time. In our study, we examined the types and timing of electronic actions performed on the EMR system by residents and found that residents spend about a third (36%) of their day in front of the computer and frequently perform many simultaneous tasks across the charts of multiple patients. Additionally, residents often do work long hours, with a median of 69.2 hours per week when on the inpatient medicine service.
Medical Research: What should clinicians and patients take away from your report?
Dr. Ouyang: Our study highlights how resident workflows have changed with the times and adapted to the use of EMR systems. This study is the first objective analysis at how residents spend their time without concern for the biases of self-reporting or having someone follow residents around during the day. Our study confirms some previously expected results – such as the fact that residents work long hours and take care of many patients – and also identifies new trends – like how computer usage peaks at the beginning of the day when residents should be ‘pre-rounding’ and computer usage continues during teaching conferences.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Ouyang: As we look towards future research, we should continue to examine how residents spend their time to see if different behaviors or activities influence patient outcomes. We can identify particularly efficient residents, and identify the particular behaviors that are specific to them, and also identify if there are specific behaviors that result in improved patient outcomes.
Ouyang D, Chen JH, Hom J, Chi J. Internal Medicine Resident Computer Usage: An Electronic Audit of an Inpatient Service.JAMA Intern Med. Published online December 07, 2015. doi:10.1001/jamainternmed.2015.6831.
David Ouyang MD (2015). Medical Residents Work Almost 70 hours per week, 1/3 on Electronic Records