EHR Algorithms Overwhelm Physician Inboxes and Contribute to Burnout

MedicalResearch.com Interview with:

Ming Tai-Seale, PhD, MPH Professor Department of Family Medicine and Public Health University of California San Diego School of Medicine 

Dr. Tai-Seale

Ming Tai-Seale, PhD, MPH
Professor
Department of Family Medicine and Public Health
University of California San Diego School of Medicine 

MedicalResearch.com: What is the background for this study?

Response: The electronic health record (EHR) potentially creates a 24/7 work environment for physicians. Its impact on physicians’ wellness has become a challenge for most health care delivery organizations. Understanding the relationships between physicians’ well-being and “desktop medicine”1 work in the EHR and work environment is critical if burnout is to be addressed more effectively.

MedicalResearch.com: What are the main findings? 

Response: Analyses of EHR work performed by physicians in a multispecialty practice found that in-basket messages generated by the EHR system accounted for almost half (114) of the 243 weekly in-basket messages received per physician, on average—far exceeding the numbers received from their colleagues (53) and patients (30). In a survey, 36 percent of the physicians reported burnout symptoms, and 29 percent intended to reduce their clinical work time in the upcoming year. Receiving more than the average number of system-generated in-basket messages was associated with 40 percent higher probability of burnout and 38 percent higher probability of intending to reduce clinical work time. Physicians’ perceptions of a positive work environment were associated with lower odds of burnout and intention to reduce clinical work time and with greater satisfaction with life. Female physicians had a higher risk of burnout and lower satisfaction with life, compared to males.  

MedicalResearch.com: What should readers take away from your report?

Response: Majority of EHR messages came not from patients but from algorithms aimed at improving patient care quality. Meaningful redesign of EHR in-basket workflow and a wellness-enhancing work environment are necessary to effectively improve physicians’ well-being. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Develop effective approaches to transform the practice of medicine in the digital age. 

Citation:

Physicians’ Well-Being Linked To In-Basket Messages Generated By Algorithms In Electronic Health Records

Ming Tai-Seale, Ellis C. Dillon, Yan Yang, Robert Nordgren, Ruth L. Steinberg, Teresa Nauenberg, Tim C. Lee, Amy Meehan, Jinnan Li, Albert Solomon Chan, and Dominick L. Frosch

Health Affairs 2019 38:7, 1073-1078

https://www.healthaffairs.org/action/showCitFormats?doi=10.1377%2Fhlthaff.2018.05509

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