Death by  a Thousand and One Clicks: Is Physician Burnout  Linked to Electronic Health Record Use?

Death by a Thousand and One Clicks: Is Physician Burnout Linked to Electronic Health Record Use?

By: Afua Aning, MD
Nov 15, 2020

Electronic health records (EHRs) and other forms of healthcare information technology have great promise to improve care, reduce costs, and create a balance in which continuous improvement is possible by utilizing data to analyze which treatments are most effective. Yet, there are a few shortcomings with most of the software interactive design that yields potential safety concerns.

A 2020 JAMA article reviewed several concerns related to physicians’ experiencing fatigue while using electronic medical records (EHRs) systems for as little as 22 minutes. The report finds EHR is a direct link to physician burnout. Physicians over the years have voiced concerns and dissatisfactions with the click-heavy, data-busy interface of existing EHRs. Other factors associated with the physician’s frustrations include scrolling through pages of notes and navigating through multiscreen workflows in the search for information. Most physicians report emotional distress due to excess screen time and limited face-to-face contact with patients resulting in high rates of medical errors. The common complaints are exhaustion, inefficient, and time-consuming.

Hospital systems depend on EHR usability for patient safety and quality of care. Poor EHR design and improper training exacerbates physician fatigue, potentially affecting decision making, causing delays in care and medical errors.

EHRs are not the sole cause of physician burnout, part of the problem is the complicated and increased documentation requirements. There are incentives for providers to maximize reimbursement from payers by documenting extensively.

Understanding and solving these problems to create exceptionally safe and usable healthcare IT will require the careful study of better design that improves efficiency (i.e. mouse click, and time), streamline decision-making processes, and support patient safety.

Some proposed studies done by MedWISE involve eye-tracking and cognitive interaction. MedWISE (Medical Widget-based information Sharing Environment) is an electronic health record (EHR) platform built to realize part of a new model for healthcare information systems.

References

Khairat, S (2020, June 9). Association of Electronic Health Record Use With Physician Fatigue & Efficiency. JAMA Network Open.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2766836

Cheney (2020, July 20). Physician Fatigue Linked to Electronic Health Record Use. Healthleaders. https://www.healthleadersmedia.com/clinical-care/physician-fatigue-linked-electronic-health-record-u....

Senathirajah, Y (2014). The Clinician In The Driver’s Seat: Part 2- Intelligent Uses Of Space In a Drag/Drop User-Composable Electronic Health Record. J Biomed Inform. https://pubmed.ncbi.nlm.nih.gov/25445921/