Electronic Health Records (EHR) are nearly ubiquitous. You can read our prior, and recent coverage of EHR [here](http://cmglaw.com/Search?q=EHR). Likewise, physician burnout has been the topic of research for decades. The American Medical Association recently published the results of a study attempting to uncover links between the two. The results, published in the Journal for the American Medical Association, reveal that stress and burnout associated with EHRs is prevalent.
The paper is the result of a survey of 282 clinicians across three separate health systems. This cohort included 41 mid-level providers; 193 of whom worked in primary care. Each completed a survey regarding burnout, stressors, and coping mechanisms. The results across clinician type and practice types were consistent.
The results revealed seven EHR design and use factors which were associated with high stress and burnout: information overload, slow system response times, excessive data entry, inability to navigate the system quickly, note bloat, interference with the patient-clinician relationship, fear of missing something, and notes geared toward billing.
Now, we may not all use EHR in our daily lives, but as a general premise most of these complaints are, I assume, familiar to all of us in navigating databases, web surfing, or even trying to find a movie to settle down in front of for the night.
The study spends some time discussing that note length has doubled in recent years as providers aim to include as much information as necessary for billing and compliance. The authors raise a valid point: we should allow notes to be structured more for clinical care than billing practices (but that requires high-level actions on the part of the clinics and governmental policy makers).
Some physicians have compensated by bringing in a scribe – the benefit is the doctor is focused on the patient rather than following along on a screen. But, as the report notes, scribes’ utility is diminished when the patient is gone. Perhaps the answer lies in greater use of Medical Assistants who can serve as scribes and further facilitators of care at the clinicians’ direction.
This is significant to you and me, consumers of medical care, if physician burnout means a declining quality of care. Burned out physicians – like professionals in any high stakes profession – make more errors. While EHR has been intended to improve the quality of care, the evolving process of designing and improving these systems is the result of exposing the flaws of prior systems. It is indeed an ever-evolving process: this research should help spur along improvements for all of us.
Read the study here: [Association of Electronic Health Record Design and Use Factors With Clinician Stress and Burnout](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2748054).
Read CMG’s prior coverage of physician burnout [here](http://cmglaw.com/Blog/2016/06/Increasing-Physician-Burn-Out-Is-A).
