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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Apr 14, 2020
Open Peer Review Period: Apr 13, 2020 - Apr 19, 2020
Date Accepted: Apr 27, 2020
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

The Influence of Electronic Health Record Use on Physician Burnout: Cross-Sectional Survey

Tajirian T, Stergiopoulos V, Strudwick G, Sequeira L, Sanches M, Kemp J, Ramamoorthi K, Zhang T, Jankowicz D

The Influence of Electronic Health Record Use on Physician Burnout: Cross-Sectional Survey

J Med Internet Res 2020;22(7):e19274

DOI: 10.2196/19274

PMID: 32673234

PMCID: 7392132

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Measuring the Influence of Electronic Health Record Use on Physician Burnout: A Canadian Mental Health Case Study

  • Tania Tajirian; 
  • Vicky Stergiopoulos; 
  • Gillian Strudwick; 
  • Lydia Sequeira; 
  • Marcos Sanches; 
  • Jessica Kemp; 
  • Karishini Ramamoorthi; 
  • Timothy Zhang; 
  • Damian Jankowicz

ABSTRACT

Background:

Physician burnout has a direct impact on the delivery of high-quality health care, with Health Information Technology tools such as Electronic Health Records (EHRs) having added to the burden of practice inefficiencies.

Objective:

This study aimed to (1) identify the extent of burnout amongst physicians and learners (residents & fellows), and explore factors associated with EHR-related burnout, including time spent in EHR, documentation styles, proficiency, training, and perceived usefulness. We also aimed to (2) address gaps in methodologies in the field of EHR-related burnout research, by determining physicians’ pattern of EHR use through usage logs.

Methods:

This study used a cross-sectional survey methodology and review of administrative data for back-end log measures of EHR use of survey respondents, conducted at a large Canadian academic mental health hospital. Chi-squared and fishers exact tests were used to examine the association of EHR related factors with general physician burnout. The survey was sent out to 474 individuals at between May and June 2019, including physicians (n=407), residents (n=53), and fellows (n=14), and we measured physician burnout and perceptions of EHR stressors, (along with demographic and practice characteristics).

Results:

Our survey had 208 respondents, including physicians (n=176) and learners (n=32) (response rates: 43.2% for physicians (75% full-time; 10% part-time), 47.7% for learners). 25.6% of practicing physicians and 18.6% of learners identified as having one or more symptoms of burnout, and 74.5% of all respondents who reported burnout symptoms, identified the EHR as a contributor. Lower satisfaction and higher frustration with the EHR were significantly associated with perceptions of EHR contributing towards burnout. Physicians and learners’ experiences with the EHR, as gathered through open-ended survey responses, identified challenges around the intuitiveness and usability of the technology, as well as workflow issues. Metrics gathered from back-end usage logs demonstrated a 13.6 minute overestimation in time spent in EHR per patient and 5.63 hour overestimation in after-hours EHR time, when compared to self-reported survey data.

Conclusions:

This study suggests that use of an EHR is one of the perceived contributors to physician burnout. There needs to be a focus on combating physician burnout through reducing the unnecessary administrative burdens of EHRs through efficient implementation of systems, and effective post-implementation strategies.


 Citation

Please cite as:

Tajirian T, Stergiopoulos V, Strudwick G, Sequeira L, Sanches M, Kemp J, Ramamoorthi K, Zhang T, Jankowicz D

The Influence of Electronic Health Record Use on Physician Burnout: Cross-Sectional Survey

J Med Internet Res 2020;22(7):e19274

DOI: 10.2196/19274

PMID: 32673234

PMCID: 7392132

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