Reason 4: Technology has become an added burden to primary care.

Technology has the potential to expand primary care access and strengthen primary care delivery. Patient portals can allow for asynchronous care, and the electronic health record (EHR) can make population health management more accessible for primary care clinicians. Telehealth can expand access to populations who have limited transportation, time off from work, or child care. Furthermore, EHR interoperability can improve care coordination across clinical settings and partnerships with public health and community-based organizations to foster comprehensive, whole-person care. Yet, if not designed, implemented, or supported adequately — and if the entire team is not involved in managing it — technology can worsen administrative burden for primary care clinicians, further fragmenting care and burning out an already overburdened workforce. In fact, recent data from the American Board of Family Medicine (ABFM) show that 16% of family physicians report spending four or more hours per day outside of patient care on EHRs.⁷⁴

If not designed, implemented, or supported adequately – and if the entire team is not involved in managing it – technology can worsen administrative burden for primary care clinicians, further fragmenting care and burning out an already overburdened workforce.

Poor “usability” may account for some of the time spent. In 2022 over 40% of family physicians gave a poor or fair rating to the “ease of finding relevant information” in their EHR (Figure 10). And half of those surveyed gave those same low scores when rating the usefulness of alerts from their EHR (Figure 10). Not surprisingly, one-quarter of family physicians were dissatisfied with their EHR (Figure 11). Although HIT has the potential to improve access for patients, these data suggest that HIT is currently a contributor to the access problem.

Figure 10. Nearly Half of Family Physicians Rate EHR Usability Poor or Fair in 2022

Data Source: American Board of Family Medicine recertification exam, 2022
Notes: A total of 2,117 respondents completed the EHR usability questions.⁷⁴

Figure 11. More Than One-Third of Family Physicians Are Not Satisfied with Their EHR in 2022

Data Source: American Board of Family Medicine recertification exam, 2022
Notes: A total of 4,261 respondents completed the EHR satisfaction questions.⁷⁴

This data could help explain why patients report access to primary clinicians is diminishing; increased workload requirements are reducing the size of patient panels that clinical teams are able to effectively manage.

---

Notes

74. Hendrix N, Bazemore A, Holmgren AJ, et al. Variation in family physicians’ experiences across different electronic health record platforms: a descriptive study. J Gen Intern Med. 2023:1-8. doi:10.1007/s11606-023-08169-5.