Author Interviews, Brigham & Women's - Harvard, Electronic Records, JAMA, Pediatrics, Primary Care / 09.07.2021
Internists and Family Practitioners Spend Hours Daily on Electronic Records and Messages
MedicalResearch.com Interview with:
[caption id="attachment_57766" align="alignleft" width="200"]
Dr. Rotenstein[/caption]
Lisa Rotenstein, MD, MBA
Assistant Medical Director
Population Health and Faculty Wellbeing
Department of Medicine
Brigham and Women's Hospital
MedicalResearch.com: What is the background for this study?
Response: Our previous work in JAMA Internal Medicine demonstrated significant differences in time spent on the electronic health record (EHR) by specialty, and specifically showed that primary care clinicians spent significantly more total and after-hours time on the EHR than surgical and medical specialty counterparts. Primary care clinicians spent twice as long as surgical colleagues on notes, and received more than twice as many messages from team-mates, five times as many patient messages, and fifteen times as many prescription messages each day.
Given these findings, the heavy administrative burden placed on primary care clinicians, and previous data about burnout among primary care clinicians, we wanted to better understand differences in time spent on the EHR among the different types of primary care clinicians.
Dr. Rotenstein[/caption]
Lisa Rotenstein, MD, MBA
Assistant Medical Director
Population Health and Faculty Wellbeing
Department of Medicine
Brigham and Women's Hospital
MedicalResearch.com: What is the background for this study?
Response: Our previous work in JAMA Internal Medicine demonstrated significant differences in time spent on the electronic health record (EHR) by specialty, and specifically showed that primary care clinicians spent significantly more total and after-hours time on the EHR than surgical and medical specialty counterparts. Primary care clinicians spent twice as long as surgical colleagues on notes, and received more than twice as many messages from team-mates, five times as many patient messages, and fifteen times as many prescription messages each day.
Given these findings, the heavy administrative burden placed on primary care clinicians, and previous data about burnout among primary care clinicians, we wanted to better understand differences in time spent on the EHR among the different types of primary care clinicians.
Dr. McPeek Hinz[/caption]
Eugenia McPeek Hinz MD MS FAMIA
Associate CMIO - DHTS
Duke University Health System
MedicalResearch.com: What is the background for this study?
Response: Clinician burnout rates have hovered around 50% for much of the past decade. Burnout is a significant concern in healthcare for its effects on care givers and associated downstream adverse implications on patient care for quality and safety. The ubiquitous presence of Electronic Health Records (EHR) along with the increased clerical components and after hours use has been a significant concern for contributing to provider burnout.
Dr. Traverso[/caption]
Carlo Giovanni Traverso, MB, BChir, PhD
Associate Physician, Brigham and Women's Hospital
Assistant Professor,
[caption id="attachment_56823" align="alignleft" width="150"]
Dr. Chai[/caption]
Peter R. Chai, MD, MMS
Emergency Medicine Physician and Medical Toxicologist
Harvard Medical School
Brigham and Women's Hospital
Department of Medicine
MedicalResearch.com: What is the background for this study? What are some of the functions that Dr. Spot can facilitate?
Response: During the COVID-19 pandemic, we wanted to consider innovative methods to provide additional social distance for physicians evaluating low acuity individuals who may have COVID-19 disease in the emergency department. While other health systems had instituted processes like evaluating patients from outside of emergency department rooms or calling patients to obtain a history, we considered the use of a mobile robotic system in collaboration with Boston Dynamics to provide telemedicine triage on an agile platform that could be navigated around a busy emergency department. Dr. Spot was built with a camera system to help an operator navigate it through an emergency department into a patient room where an on-board tablet would permit face-to-face triage and assessment of individuals.


Dr. Gardner[/caption]
Rebekah L Gardner MD
Associate Professor of Medicine
Warren Alpert Medical School
Brown University
Providence, Rhode Island
MedicalResearch.com: 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.





