Pressure of Electronic Medical Record Documentation Contributing to Physician Burnout Interview with:

Rebekah L Gardner MD Associate Professor of Medicine Warren Alpert Medical School Brown University Providence, Rhode Island

Dr. Gardner

Rebekah L Gardner MD
Associate Professor of Medicine
Warren Alpert Medical School
Brown University
Providence, Rhode Island What is the background for this study? What are the main findings?

Response: Burnout profoundly affects physicians, their patients, and the health care system.The role of technology in physician burnout, specifically health information technology (HIT), is not as well characterized as some of the other factors. We sought to understand how stress related to HIT use predicts burnout among physicians.

Our main findings are that 70% of electronic health record (EHR) users reported HIT-related stress, with the highest prevalence in primary care-oriented specialties. We found that experiencing HIT-related stress independently predicted burnout in these physicians, even accounting for other characteristics like age, gender, and practice type. In particular, those with time pressures for documentation or those doing excessive “work after work” on their EHR at home had approximately twice the odds of burnout compared to physicians without these challenges. We found that physicians in different specialties had different rates of stress and burnout. What should readers take away from your report?

Response: Readers should know that, among the physicians we surveyed, HIT-related stress was measurable, prevalent, and specialty-related. Among the HIT-related stress measures we looked at, insufficient time for documentation most strongly predicted burnout symptoms. It remained statistically significant, even when controlling for how much physicians used their EHRs at home.

Based on our results and the work of others, we recommend that health care organizations regularly and systematically measure HIT-related stress and burnout among their workforce. Analyses should stratify by specialty, as we found substantial differences in the types of HIT-related stress experienced by doctors doing different types of work; the specific remedies for HIT-related stress may also vary by specialty. What recommendations do you have for future research as a result of this work?

Response: We recommend that future research focus on organizations systematically identifying opportunities to reduce HIT-related stress in their workforce and then implementing evidence-based interventions to target the issues. Then the organizations should re-measure to see if the interventions made a difference. This same approach can be used to monitor the effect of new policies and the introduction of new technology in a particular environment.

Any disclosures?

The Rhode Island Department of Health funded this work. 


Rebekah L Gardner, Emily Cooper, Jacqueline Haskell, Daniel A Harris, Sara Poplau, Philip J Kroth, Mark Linzer; Physician stress and burnout: the impact of health information technology, Journal of the American Medical Informatics Association, , ocy145, 

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Dec 6, 2018 @ 11:22 pm

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