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Research Indicates EHR, CPOE Use Linked to Physician Burnout, Dissatisfaction

June 29, 2016
by Heather Landi
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Many in the healthcare industry have been saying for years that the use of health IT plays a role in physician burnout, now a new study from The Mayo Clinic supports that theory. According to a national study of physicians led by Mayo Clinic, the use of electronic health records (EHRs) and computerized physician order entry (CPOE) leads to lower physician satisfaction and higher rates of professional burnout.

The study was funded by the Mayo Clinic Program on Physician Well-being and the findings appear in Mayo Clinic Proceedings. For the study, researchers from Mayo Clinic collaborated with investigators from the American Medical Association (AMA) to assemble a national sample of U.S. physicians using AMA Physician Masterfile. The study used data from 6,560 physicians in active clinical practice surveyed between August and October 2014 and included physicians from all specialties in the U.S.

According to a press release about the study, physicians provided information regarding use of EHRs, CPOE and electronic patient portals and researchers used validated instruments to assess burnout.

The study findings indicated that physicians who used EHRs and CPOE systems had lower satisfaction due to the amount of time spent on clerical tasks, which put those physicians at a higher risk for professional burnout.

And, the study found that physician satisfaction with clerical burden, EHRs and CPOE varied dramatically by specialty. Family medicine physicians, urologists, otolaryngologists and neurologists were among the specialties with the lowest satisfaction with clerical burden. The researchers found that use of CPOE was the characteristic of the electronic practice environment most strongly associated with the risk of burnout.

“Electronic health records hold great promise for enhancing coordination of care and improving quality of care,” Tait Shanafelt, M.D., Mayo Clinic physician and lead author of the study, said in a statement. “In their current form and implementation, however, they have had a number of unintended negative consequences including reducing efficiency, increasing clerical burden and increasing the risk of burnout for physicians.”

In addition, Shanafelt stated that burnout has been shown to erode quality of care, increase risk of medical errors, and lead physicians to reduce clinical work hours, “suggesting that the net effect of these electronic tools on quality of care for the U.S. health care system is less clear.”

The issue of physician burnout and what role health IT might play in physician dissatisfaction has been the focus of many studies. As Healthcare Informatics Contributing Editor David Raths previously reported, several health systems have teamed up in a two-year AHRQ-funded study of the factors associated with clinician stress and burnout. The first phase of that study focused on determining the reasons health IT contributes to stress or burnout and possible solutions to inform better user interface design.

As Raths reported, the message from many of the participants in the focus groups as part of that study is that they are spending too much time with EHRs at home, as the amount of time required for documentation requires either staying late at work or doing the documentation at home. In fact, 56 percent of the respondents in those particular focus groups felt that the amount of time spent on EHRs at home was “excessive” or “moderately high.”

In the conclusion to the Mayo Clinic study, researchers recommended finding ways to incorporate health IT tools in a manner that does not increase clerical burden for physicians or reduce their efficiency in order to mitigate the negative effects of the electronic environment on physicians.

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