Study Finds EHR Communication Methods Hinder Care Team Well-Being

While clinicians reported the EHR as the dominant communication modality across teams, they noted that EHR-based communication negatively affects care team well-being, according to a study published in JAMA Network Open.

Researchers conducted a secondary qualitative analysis of semistructured interview data from two studies. Two healthcare organizations in California from March 16 to October 13, 2017, and February 28 to April 21, 2022, participated. Respondents included attending and resident physicians.

Interviewees noted that the EHR has improved communication for simple tasks. However, the study found that the EHR has limited rich, social communication required to build relationships, solve complicated clinical problems, and navigate conflict.

Clinicians perceived that the EHR negatively impacts team function by amplifying disagreement and introducing conflict based on medical-legal pressure and undefined communication norms for the EHR.

Additionally, physician frustration with the EHR may affect interactions with the team, damaging team member well-being.

“Our results suggest that the EHR supports looser forms of interprofessional work, such as networking and coordination, at the expense of more intense collaboration and teamwork,” the study authors wrote.

The findings emphasize the need for in-person conversation to build relationships via social connection and address areas of conflict.

“Social interaction, minimized by the EHR, is key for the development of workplace trust, meaning, and satisfaction,” they wrote. “Our results confirm past findings around the importance of face-to-face interaction in supporting physician well-being. Direct interaction may mediate EHR-related physician distress and enable physicians to build relationships and address conflict.”

Additionally, virtual team communication strategies that support rich and social communication, such as discussing conflicts over a video call or securing protected time for virtual social communication, could help address some EHR-related communication challenges.

Another major finding of the study centered around the EHR and physician well-being. Most studies investigating the association between team function and physician well-being have focused on the role that team function may play in clinician well-being.

However, the new study explores a reverse connection, which suggests that fostering physician well-being may benefit team function and mitigate unprofessional behaviors instigated by physician distress.

“Our findings suggest that understandings of optimal EHR use are needed and that the development and improvement of local work culture is critical and may have a greater influence on physician burnout than EHR improvements alone,” the authors wrote. “Solutions focused on the cultivation of team connection and trust can be highly productive, even as the EHR continues to be used appropriately.”

For instance, the researchers suggested that organizations support physicians in implementing small, structured peer-group discussions to enhance team function and individual well-being.

“Improving team stability may also enable teams to establish norms around face-to-face and EHR-related communication modalities,” they concluded.