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AMA Study Shows Poor EHR Usability Leads to Physician Burnout

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November 18, 2019

Respondents to The American Medical Association study gave EHR usability a failing grade.High volumes of data entry and poor usability associated with electronic health records (EHRs) are a main cause of physician burnout, according to a study completed in a partnership between the American Medical Association (AMA).

“A new study issued today found electronic medical records (EHRs) – as currently designed, implemented and regulated – lack usability as a necessary feature, resulting in EHRs that are extremely hard to use compared to other common technologies,” said AMA President Patrice Harris in a statement.

“While the study was conducted by leading clinical institutions in collaboration with the American Medical Association (AMA), the findings will not come as a surprise to anyone who practices medicine,” continued Harris. “Too many physicians have experienced the demoralizing effects of cumbersome EHRs that interfere with providing first-rate medical care to patients.”

In a survey of over 5,000 physician EHR users, the researchers found that EHR usability largely received an “F” rating when evaluating a standardized metric of technology usability. And those “F” grades were strongly tied to high physician burnout scores.

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Conversely, the researchers observed a significantly lessened likelihood for physician burnout when EHRs were more usable. With each one percentage point increase in EHR usability scores, the researchers observed 3 percent lower odds of physician burnout. In other words, the more easier an EHR is to use, the less likely the physician user will experience burnout symptoms.

“It is a national imperative to overhaul the design and use of EHRs and reframe the technology to focus primarily on its most critical function – helping physicians care for their patients,” said Harris. “Significantly enhancing EHR usability is key and the AMA is working to ensure a new generation of EHRs are designed to prioritize time with patients, rather than overload physicians with type-and-click tasks.”

Physician burnout is common issue with the emergence and prevalence of EHRs. High volumes of data entry is tied to high levels of physician attrition, depression, dissatisfaction, and burnout. According to the AMA, the burnout rate for physicians is about 44 percent, which is much higher than other professions.

In an effort to reduce physician burnout, the AMA put together a framework of eight priorities to improve EHR usability and configuration:

  • Enhance physicians’ ability to provide high-quality patient care
  • Lessen cognitive workload
  • Support team-based care
  • Encourage care coordination
  • Facilitate digital and mobile patient engagement
  • Expedite user input into product design and post-implementation feedback
  • Offer product modularity and configurability
  • Promote data liquidity

Following these eight priorities should enhance the user experience, reduce the number of clicks, scrolls, and screen changes. Once the user experience is enhanced, the physician can spend more face-to-face time with the patient.

“Through its ongoing work, the AMA is committed to help physicians and their practices thrive so they can continue to put patients first,” concluded Harris. “Through our research, collaborations, advocacy and leadership, the AMA is working to make the patient‐physician relationship more valued than paperwork, preventive care the focus of the future, technology an asset and not a burden, and physician burnout a thing of the past.”

The issue of clinician burnout and EHR use has received considerable industry attention as of late. Medical researchers are beginning to develop strategies to optimize EHR usability and make a dent in the clinician burnout issue.

At the University of Pittsburgh School of Medicine, a new system called MedWISE, an EHR add-on may work to address physician burnout and limit screen changes.

Yalini Senathirajah’s EHR add-on allows physicians to see all necessary medical information on the same screen, letting the physician choose which elements belong together on the screen.

Senathirajah, an associate professor of biomedical informatics, is currently testing it to see if the add-on helps physicians get the information they need without the cognitive load and potential for errors associated with most modern EHRs.

A physician using a standard EHR to order tests, check patients’ health history, and proceed with a patient’s care, takes roughly 100 clicks, the Pitt researchers suggested. Other studies have indicated that EHR use can result in thousands of clinician mouse clicks.

Using MedWise, doctors can assemble information from a system’s existing EHR into tiles, and rearrange them on the same screen to create a new EHR element, Senathirajah described. An example would be a physician creating a color-code element or specialty-specific item.

“You (might) put all the important things in red and put them on the right,” she said. “And then pull up brain scans and code them blue,” she explained.

Source: EHR Intelligence

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