EHR technology may not be driving physicians to quit practicing medicine, according to new research from the University of Notre Dame.
The researchers found no correlation between EHR adoption and physician retirement, contradicting the opinions of some healthcare leaders, who believe that there is a direct link between EHR technology and physician burnout.
“Instead, presumably due to labor market shortages and a skill set that is not specific to one particular institution, physicians were able to exercise sufficient agency to switch affiliations,” the researchers wrote.
The team also determined physicians in the prime of their careers are less likely to be affected by disruptions in hospital operations caused by new technologies and instead are likely to adapt to changes.
Basic EHR systems may have helped to increase physicians’ tenure at hospitals, while advanced EHR technology may contribute to instances of physicians moving from one hospital to another.
“While basic EHR systems led to an increased duration of stay of physicians, advanced EHR systems that require the physicians to alter and update their routines, accelerates physician departure from the organization,” wrote the researchers.
Researchers analyzed the movement of physicians within Florida hospitals using data on employment from the Florida Agency for Health Care Administration (AHCA) about bed-level admissions between 2000 and 2010.
“This allows us to track physician movement over the course of their career,” wrote researchers.
Researchers also analyzed data about EHR adoption from HIMSS Analytics. Together, this information offered the team insight into the relationship between EHR use and physician employment.
“Specifically, we look at how this usage affects the decision of physicians to continue practicing at their current hospital,” said Notre Dame professor of IT, Analytics, and Operations Corey Angst in a press release about the study.
The team also found that physicians who leave one hospital for another opt to move to a hospital that does not have an advanced EHR system in place.
“This further supports our conjecture that they flee to avoid significant learning costs and disruptions to their routines,” the team said.
Finally, researchers determined disruptions to daily physician routines caused by additional IT implementations may accelerate a physician’s departure.
“These findings highlight the degree to which administrators must consider their environment before making any adoption decision,” stated the study.
Overall, basic EHR functionality appears to be a boon to clinical efficiency and provider satisfaction.
“Results suggest that when EHRs create benefits for doctors, such as reducing their workloads or preventing costly errors, their duration of practice increases significantly,” said Angst.
“However, when technologies force doctors to change their routines, there is an obvious exodus, though it’s more pronounced with older doctors, especially specialists, and those who have been disrupted in the past by IT implementations,” he explained.
Physicians appear to favor EHR systems that do not require significant modifications or changes to daily processes. Advanced EHR systems — which Notre Dame researchers classified as systems utilizing computerized physician order entry (CPOE) or physician documentation (PD) — are less appealing to clinicians.
“Most doctors don’t want to have to look at a screen and document what the patient is saying while doing an exam,” Angst says. “The PD module requires doctors to either document the things they are doing at the moment of the exam or immediately following — or they have to employ a scribe to do it while they are doing the patient exam.”
While introducing basic EHR systems into hospitals and physicians’ offices may not contribute to physician burnout, functionality that requires physicians to significantly change their routines can drive clinicians to leave one hospital for another.