EHR, CPOE use linked to physician burnout and dissatisfaction

Doctors’ dissatisfaction with electronic systems is linked to requirements to perform clerical tasks, survey results show.

The use of electronic health records and computerized physician order entry is resulting in lower doctor satisfaction and higher rates of professional burnout, according to the results of a national survey of practicing physicians.

Results of the study, published in Mayo Clinic Proceedings, showed that doctors’ satisfaction with their EHRs and CPOE was generally low because of the amount of time spent on clerical tasks, and as a result, those physicians were at higher risk for professional burnout. In addition, researchers found that use of CPOE was the characteristic of the electronic practice environment most strongly associated with the risk of burnout.

The study of 6,560 physicians, surveyed between August and October of 2014, was led by the Mayo Clinic and conducted in collaboration with investigators from the American Medical Association.

Professional burnout is a syndrome characterized by exhaustion, cynicism and feelings of ineffectiveness, according to Tait Shanafelt, MD, a researcher at the Mayo Clinic. “Physician burnout has been linked to decreased quality of care and medical errors as well as an increase in the likelihood physicians will cut back their work hours or leave the profession,” he says.

Physicians across all specialties were surveyed, providing information regarding their use of EHR systems, CPOE and patient portals, with satisfaction varying dramatically by specialty. Researchers found that family medicine physicians, urologists, otolaryngologists and neurologists were among the specialties with the lowest satisfaction rate with EHRs because of the increased clerical burden.

“We need to find ways to incorporate EHRs, patient portals and electronic order entry in a way that does not increase clerical burden for physicians or reduce their efficiency,” says Shanafelt, lead author of the study. “A variety of innovative approaches, such as using medical scribes, having nurses filter and respond to electronic messages from patients and having support staff handle questions using verbal communication rather than electronic messaging, have all been found to improve efficiency,” he says.

Sachin Jain, MD, chief medical officer of healthcare system/health plan CareMore, contends that frontline physicians have never felt more burdened and burned out than they do right now.

“The data from physician burnout surveys are just getting worse year after year,” Jain on Tuesday told the Healthcare Financial Management Association's Annual National Institute in Las Vegas. “They feel like the system is aligning to make their work and their jobs difficult.”

The Electronic Health Record Association declined to comment on the results of the study and survey data.

This isn’t the first time an AMA-associated survey has shown these kinds of results. In 2013, AMA and RAND Corp. conducted a study in which doctors identified EHRs as the leading cause of professional dissatisfaction, emotional fatigue, depersonalization and lost enthusiasm. Specifically, doctors described poor EHR usability that did not match clinical workflows, time-consuming data entry, interference with face-to-face patient care, and overwhelming numbers of electronic messages and alerts.

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