P087 Electronic health records, the burden of clinical administration in dermatology and the law of conservation of admin in Wales

Abstract

The increasing administrative workload faced by dermatologists has become a significant concern, impacting clinical efficiency, job satisfaction and patient care. We evaluate changes in clinical administration over the past 5 years, exploring the impact of electronic health records (EHRs), administrative staffing, workload intensity and works to apply a formula to the conservation of administrative duties. An anonymous survey of dermatologists assessing changes in administrative workload, efficiency and support structures was undertaken in Wales. In total, 24 of 40 dermatology consultants responded. Sixteen respondents (67%) reported a substantial increase in the amount of clinical administration over the past 5 years, with only one stating it remained unchanged. Nine (38%) strongly agreed that the intensity of administrative work had increased, while only one (4%) believed it had decreased. Thirteen (54%) noted that administration tasks had increasingly taken up their Supporting Professional Activities time. Concerning EHRs, six respondents (25%) found EHRs beneficial, while eight (33%) disagreed or strongly disagreed. Common complaints included inefficiency, system crashes and increased time required for tasks previously handled by secretarial staff. However, some acknowledged benefits, such as faster access to results and clinic letters. Administrative staffing support has decreased, with 12 (50%) respondents reporting a reduction in secretarial assistance and only 1 (4%) stating an improvement. Many reported performing tasks previously done by medical secretaries, clinic coordinators or specialist nurses. Administrative burden can be quantified by the time taken to perform it (Ta). This is directly proportional to the number of tasks (n) and their intensity (I), and inversely proportional to the people performing it (p). The formula Ta = A(nI)/p summarizes this, with A being the administrative constant. EHR implementation has increased I. Redistribution of administrative duties to consultants reduces p. T is increased as a result, which drives the negative impacts listed above.