Affiliation:
1. University of California San Diego School of Medicine La Jolla California USA
2. Rady Children's Hospital San Diego California USA
Abstract
AbstractIn the United States, clinical work had been primarily compensated via a relative value unit (RVU) system reliant on professional surveys estimating the value of clinical care events. However, with the advent of time‐based billing in 2021, time accounting has become an important work compensation metric. The Signal functionality within Epic, the most widely used electronic medical record (EMR) system in North America, tracks clinician time within the system. We extracted Epic Signal data from 10,200 gastroenterologists at 356 North American institutions for analysis. Workload metrics were reported as group median (interquartile range) per month and comparisons were performed using nonparametric testing. Gastroenterologists exhibit different EMR time patterns based on clientele and practice arenas. Compared with counterparts, pediatric and academic gastroenterologists spend more time at each encounter which had not been compensated under prior RVU valuations. Clinical compensation benchmarks should be driven by time‐based workload metrics to ensure appropriate compensation.
Reference14 articles.
1. CalsynM TwomeyM.Rethinking the RUC: Reforming How Medicare Pays for Doctors’ Services. 2018.https://www.americanprogress.org
2. American Medical Association.Introduction to the RUC. 2021. Accessed February 20 2024.https://www.ama-assn.org/system/files/2021-04/introduction-to-the-ruc.pdf
3. The impact of time spent on the electronic health record after work and of clerical work on burnout among clinical faculty
4. Association of Time-Based Billing With Evaluation and Management Revenue for Outpatient Visits
5. Definitive Healthcare. Most common hospital EHR systems by market share. 2023. Accessed February 20 2024.https://www.definitivehc.com/blog/most-common-inpatient-ehr-systems