Outside of the copy and paste method, EHR efficiency tools do not reduce clinician burnout.
Increased clinician workload, primarily due to a high volume of patient call messages in the EHR inbox, is the predominant cause of clinician burnout according to a study published in the Journal of the American Medical Informatics Association (JAMIA).
To that end, EHR efficiency tools are unlikely to reduce burnout symptoms, the study authors asserted.
An abundant number of studies have shown that a high EHR workload is a primary cause of clinician burnout. And although there is an increasing amount of analysis and awareness on the subject, researchers are still trying to uncover and test approaches to mitigate clinician burnout.
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Researchers gathered data from a Rhode Island clinician survey on burnout with EHR data from two large health systems that included over 400 clinicians.
Using this data, researchers assessed whether EHR workload and efficiency was directly associated with clinician burnout. Ultimately, the research group’s goal was to uncover multiple factors of burnout, leading to interventions to decrease this common consequence.
“We identified the inbox volume of patient call messages as the most significant predictor of self-reported burnout among clinicians,” wrote the study authors.
Specifically, clinicians with the highest number of patient call messages, even when controlling for demographic, practice characteristics, and workload measures, had almost four times the odds of clinician burnout compared to clinicians who faced the fewest number of patient call messages.
This category consists of telephone inquiries and EHR inbox tasks such as medication refills, disability paperwork, prior authorization forms, communication between clinicians, and many more.
“PCPs had the largest burden of these messages, along with a higher burden of results and orders,” wrote the study authors. “Perhaps the call volume measure is associated with increased burnout because virtually all of the tasks are uncompensated.”
Surprisingly, no other workload measures, such as implemented EHR efficiency tools, were significantly associated with burnout. This suggests the EHR tools and strategies that were deployed in these two hospitals did not decrease clinician burnout.
However, a subset of questions showed clinicians who utilized copy and paste for note content more frequently were significantly less likely to report clinician burnout.
While compensation could be connected to burnout, researchers also hypothesized after-work EHR use, lack of control over EHR workload, and an added digital skill-set that is not connected to physicians could be causing burnout.
This is yet another example that shows how an increased EHR workload has a direct correlation to clinician burnout and reducing the EHR workload would be a step in the right direction of reducing burnout and stress.
“In addition to delegating appropriate inbox messages to nonphysician staff and improving EHR usability, we recommend that future studies explore prospectively testing a model of EHR use characteristics predictive of burnout, so that individual institutions could provide customized assistance to clinicians.”
Numerous other studies have connected extensive EHR use to clinician burden.
According to a prior study published in JAMIA, one-third of clinicians experienced high cynicism, and over half reported high exhaustion levels that were directly caused by extensive EHR use.
The study found that clinicians who had greater than 307 EHR messages per week had 6.17 greater odds of experiencing high-level exhaustion and clinician burnout.
“Our study brings important empirical evidence to the widely asserted contribution of EHRs to clinician burnout,” wrote the authors of the previous study. “We found that 2 objective, vendor-defined measures of EHR use—time spent after hours on the EHR and volume of inbox messages—are related to exhaustion.”
Source: EHR Intelligence