Electronic health records (EHRs) are inextricably linked to physician burnout. But reporters should be careful about placing all the blame on EHRs for the widespread problem that affects as many as half of clinicians and costs the industry billions per year.
A new study published in JAMA Open Network indicated that EHR systems create “information overload.“ But other workplace factors may contribute even more to burnout, the study of 280 clinicians at three medical centers concluded.
Other drivers of clinician burnout cited in the study were:
- Chaotic office atmosphere
- Lack of control over workload
- Poor work/life balance
- Values misalignment with leadership
- Lack of time for documentation at work
EHRs did contribute to stress and burnout in the form of seven EHR design and use factors, which included: excessive data entry; inability to navigate information quickly; and “note bloat“ – the unnecessarily long cut-and-pasting of progress notes. Documentation for billing purposes was called out as a contributor to stress and burnout among U.S. physicians due to the complex requirements for billing compliance to satisfy multiple insurers.
Some 45% of those clinicians surveyed in the JAMA Open Network study experienced burnout.
Burnout is an important topic because it adversely affects patient quality of care and the stability of the health care workforce.
Physician burnout (not including nurses, who also experience high levels of burnout) costs the health care industry between $2.6 billion and $6.3 billion annually, according to a June 2019 study in the Annals of Internal Medicine. Costs are related to turnover and reduced clinical hours, with an estimated annual organizational cost of $7,600 per employed physician.
In 2017, 44% of U.S. physicians reported at least one symptom of burnout, according to a study in Mayo Clinic Proceedings and funded in part by the American Medical Association. Burnout fell from a peak in 2014 (back to 2011 levels) but physicians remain at higher risk of burnout compared to workers in other fields, according to the study, which included breakdowns by specialty, gender and age.
EHRs can be improved to reduce factors that contribute to burnout with better interfaces and by decoupling EHR documentation from billing practices, according to the JAMA Open Network study.
But the authors concluded that while EHR design and use should be addressed by health systems to help alleviate stress and burnout “other non-EHR issues, especially clinician work conditions, appear to play a substantial role in adverse clinician outcomes.”