Electronic Health Records

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EHR Use Continues to Contribute to Physician Burnout

EHR use is nearly ubiquitous among hospitals in the United States, but has it come at a cost of physician productivity and satisfaction?

By Kyle Murphy, PhD

A recent survey of primary care physicians found EHR technology as the second most-commonly cited factor contributing to physician burnout. EHR use came in behind time pressures as the most frequently reported stressor.

According to one respondent to the InCrowd survey noted that physician EHR use "nearly double the time and expense of medical practice for most direct patient care physicians, including physicians in training, without increasing any type of reimbursement."

For two specialties in particular — primary care and emergency medicine — more than half of respondents (57%) reported having personally experienced burnout, defined as "decreased enthusiasm for work, depersonalization, emotional exhaustion, and a low sense of personal accomplishment." More than one-third of respondents (37%) knew of colleagues who had experienced physician burnout. A similar percentage expressed experiencing frustration as a result of their week on a daily or weekly basis.

The most disturbing takeaway from the survey? A sizeable majority of physicians (74%) contend that their facilities or practices are not taking sufficient action to address physician burnout.

In an interview with American Medical Association President Steve Stack, MD, earlier this year, the emergency physician spoke at length about the realities of physician burnout.

 "Doctors will get behind things that support better quality of care and support them in their clinical practice. It's the nonsensical stuff that makes it infuriating and challenging," Stack told EHRIntelligence.com.

"When we are going to get adverse consequences to ourselves or hospitals by complying with the current thinking in medical treatment rather than outdated quality reporting and regulation," he continued, "those sorts of things are good examples where regulation is not a good tool at times to try to keep up with the fast pace of medical innovation, and good intentions can lead to undesired adverse consequences."

AMA President Steve Stack, MD, talks physician burnout

According to Stack, the rise in physician burnout — Mayo Clinic Proceedings reported a significant uptick in physicians reporting at least one sign of burnout over the past several years from, 45 percent in 2011 to 54 percent in 2014 — is a serious threat to patient safety.

"Now when physicians get burned out, they feel overworked, overburdened, overstressed, under-supported — just like anyone in any other profession, except that in this profession people rely on us to make very high-stakes decisions that directly impact their health and if we don't get it right, the consequences are not retrievable unfortunately at times," he maintained.

Stack cited EHR use as having a hand in physician burnout.

"Electronic health records have a great amount of promise," he explained. "Many doctors actually enjoy a lot of facets of their EHRs — the ready access to information, the ability to see historical information, the ability to share information with other doctors, other clinicians, and their patients directly so that patients can be more informed. Those are all good things, but there are many other aspects of the EHR that are frustrating. They are inefficient to use. They don't talk to each other. They cost a lot of money. When they crash or go down, it paralyzes our ability to do our work and care for patients."

Two members of the HIMSS Physician Community recently shone a light on five barriers to health IT usability and potential solutions for mitigating them:

  • Navigation
  • Data entry
  • Structured documentation
  • Interoperability
  • Clinical decision support

The solution to the first and last comes to studying clinical workflows and adapting EHR use in particular to support the complexity of physician decision-marking, write David Schlossman, MD, PhD, FACP, MS, and Nancy Staggers, PhD, RN, FAAN.

The solutions to the remaining health IT burdens require a deep analysis of the technical capabilities and limitations of current health IT and EHR systems.




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