scholarly journals Electronic Health Record Reform: An Alternative Response to Physician Burnout

2021 ◽  
Vol 134 (9) ◽  
pp. e498
Author(s):  
Howard Mertz
Keyword(s):  
Electronic Health Record ◽  
Health Record ◽  
Physician Burnout ◽  
Alternative Response ◽  
Electronic Health

Improving physician wellness through electronic health record education

2021 ◽  
pp. 009121742110346
Author(s):  
Elizabette Johnson ◽  
Elizabeth Roth
Keyword(s):  
Electronic Health Record ◽  
Statistical Significance ◽  
Resident Physician ◽  
Health Record ◽  
Physician Burnout ◽  
Paired Data ◽  
Post Intervention ◽  
Physician Wellness ◽  
Resident Wellness ◽  
Electronic Health

Objective Our goal is to improve the wellness of our Family Medicine residents now and in the future by educating them on more efficient use of our electronic health record (EHR). Resident physician burnout is a significant problem and is correlated with time spent using an EHR after work hours. Family physicians have the highest rate of burnout of all specialties, and the EHR is a significant contributor to this burnout. Studies have shown that increased EHR education can improve job satisfaction. Method Over 5 months, we provided weekly brief (15 minute) educational sessions covering 6 topics twice and a one-hour individualized meeting of each resident physician with an EHR trainer. We evaluated our intervention with wellness surveys and objective measures of EHR efficiency both pre and post intervention. We further evaluated efficiency by comparing pre and post-intervention values of the following: average keystrokes, mouseclicks, accelerator use, minutes per encounter and percent closed encounters at month’s end. Results Resident questionnaires showed lessons increased knowledge and intention to use EHR accelerators, but this was not statistically significant. Analysis of objective data showed most efficiency metrics worsened, though most not to a degree that was statistically significant. Residents reported subjective increases in efficiency, and paired data from wellness surveys showed an overall decrease in burnout post-intervention vs. baseline. Conclusions Much of the data in this pilot study does not reach statistical significance, but is highly suggestive that increased EHR training can improve at least perceived efficiency and thereby resident wellness.

scholarly journals Electronic Health Record Use among Ophthalmology Residents while on Call

2020 ◽  
Vol 12 (02) ◽  
pp. e143-e150
Author(s):  
Christopher P. Long ◽  
Ming Tai-Seale ◽  
Robert El-Kareh ◽  
Jeffrey E. Lee ◽  
Sally L. Baxter
Keyword(s):  
Internal Medicine ◽  
Electronic Health Record ◽  
Chart Review ◽  
Health Record ◽  
Physician Burnout ◽  
Single Institution ◽  
Clinical Exposure ◽  
Future Studies ◽  
After Hours ◽  
Electronic Health

Abstract Background As electronic health record (EHR) use becomes more widespread, detailed records of how users interact with the EHR, known as EHR audit logs, are being used to characterize the clinical workflows of physicians including residents. After-hours EHR use is of particular interest given its known association with physician burnout. Several studies have analyzed EHR audit logs for residents in other fields, such as internal medicine, but none thus far in ophthalmology. Here, we focused specifically on EHR use during on-call shifts outside of normal clinic hours. Methods In this retrospective study, we analyzed raw EHR audit log data from on-call shifts for 12 ophthalmology residents at a single institution over the course of a calendar year. Data were analyzed to characterize total time spent using the EHR, clinical volume, diagnoses of patients seen on call, and EHR tasks. Results Across all call shifts, the median and interquartile range (IQR) of the time spent logged into the EHR per shift were 88 and 131 minutes, respectively. The median (IQR) unique patient charts accessed per shift was 7 (9) patients. When standardized to per-hour measures, weekday evening shifts were the busiest call shifts with regard to both EHR use time and clinical volume. Total EHR use time and clinical volume were greatest in the summer months (July to September). Chart review comprised a majority (63.4%) of ophthalmology residents' on-call EHR activities. Conclusion In summary, EHR audit logs demonstrate substantial call burden for ophthalmology residents outside of regular clinic hours. These data and future studies can be used to further characterize the clinical exposure and call burden of ophthalmology residents and could potentially have broader implications in the fields of physician burnout and education policy.

scholarly journals Back to the Future: Portable Word Processors and the Electronic Health Record

2019 ◽  
Vol 34 (s1) ◽  
pp. s104-s105
Author(s):  
Alfredo Mori
Keyword(s):  
Electronic Health Record ◽  
Emergency Departments ◽  
Extreme Environments ◽  
Health Record ◽  
Physician Burnout ◽  
Software And Hardware ◽  
Electronic Health ◽  
Professional Writers ◽  
Word Processors

Introduction:The Electronic Health Record (EHR) is now the standard means for recording and maintaining medical notes in most emergency departments. The EHR is an independent cause of physician burnout, and maintenance of the EHR may occupy 30 to 50% of clinical time. There are software solutions available, but they are connected to fixed, expensive, distracting, and bright electronically powered computers. Scribes have been successfully trialed, but are also expensive and attached to computers on wheels. Portable digital word processors in the form of the AlphaSmart Neo is a redundant technology designed primarily for children with typing difficulties. It has recently enjoyed a resurgence in popularity among professional writers, journalists, and field researchers for the ultimate distraction-free writing experience. The Alphasmart Neo is cheap, nearly indestructible, intuitive, and requires almost no recharging. It is compatible with all software across Mac OS, Windows, and Linux. Notes are entered by the clinician or scribe, independently of computers, at the bedside, and uploaded to any software via USB cable.Aim:To describe the introduction and impact of the AlphaSmart Neo on the EHR in emergency departments across Australia.Methods:We will examine the role of the Alphasmart Neo in austere, low power, extreme environments with a demonstration on how to enter, maintain, and transfer an electronic health record independent of any computer or power source.Discussion:We believe the AlphaSmart Neo is an ideal, personalized, cheap, effective, and efficient hardware solution to entering notes independent of other software and hardware. It is distraction free at the patient’s bedside, resulting in better notes that the clinician enjoys writing.

Physician Burnout in the Electronic Health Record Era

2019 ◽  
Vol 170 (3) ◽  
pp. 216 ◽  
Author(s):  
N. Lance Downing ◽  
David W. Bates ◽  
Christopher A. Longhurst
Keyword(s):  
Electronic Health Record ◽  
Health Record ◽  
Physician Burnout ◽  
Electronic Health

Physician Burnout in the Electronic Health Record Era: Are We Ignoring the Real Cause?

2018 ◽  
Vol 169 (1) ◽  
pp. 50 ◽  
Author(s):  
N. Lance Downing ◽  
David W. Bates ◽  
Christopher A. Longhurst
Keyword(s):  
Electronic Health Record ◽  
Health Record ◽  
Physician Burnout ◽  
The Real ◽  
Electronic Health

scholarly journals Using a New Model of Electronic Health Record Training to Reduce Physician Burnout: A Plan for Action (Preprint)

2021 ◽  
Author(s):  
Vishnu Mohan ◽  
Cort Garrison ◽  
Jeffrey A Gold
Keyword(s):  
Electronic Health Record ◽  
Health Care Organizations ◽  
Significant Proportion ◽  
Working Hours ◽  
Well Being ◽  
The United States ◽  
Health Record ◽  
Physician Burnout ◽  
Catch Up ◽  
Electronic Health

UNSTRUCTURED Physician burnout in the United States has been growing at an alarming rate, and health care organizations are beginning to invest significant resources in combating this phenomenon. Although the causes for burnout are multifactorial, a key issue that affects physicians is that they spend a significant proportion of their time interacting with their electronic health record (EHR) system, primarily because of the need to sift through increasing amounts of patient data, coupled with a significant documentation burden. This has led to physicians spending increasing amounts of time with the EHR outside working hours trying to catch up on paperwork (“pajama time”), which is a factor linked to burnout. In this paper, we propose an innovative model of EHR training using high-fidelity EHR simulations designed to facilitate efficient optimization of EHR use by clinicians and emphasize the importance of both lifelong learning and physician well-being.

scholarly journals Physician Burnout and Timing of Electronic Health Record Use

ACI Open ◽  
2020 ◽  
Vol 04 (01) ◽  
pp. e1-e8 ◽  
Author(s):  
Mark A. Micek ◽  
Brian Arndt ◽  
Wen-Jan Tuan ◽  
Elizabeth Trowbridge ◽  
Shannon M. Dean ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Electronic Health Record ◽  
Work Hours ◽  
Care Practice ◽  
Health Record ◽  
Physician Burnout ◽  
After Hours ◽  
Electronic Health ◽  
The Relationship

Abstract Background Rates of burnout among physicians have been high in recent years. The electronic health record (EHR) is implicated as a major cause of burnout. Objective This article aimed to determine the association between physician burnout and timing of EHR use in an academic internal medicine primary care practice. Methods We conducted an observational cohort study using cross-sectional and retrospective data. Participants included primary care physicians in an academic outpatient general internal medicine practice. Burnout was measured with a single-item question via self-reported survey. EHR time was measured using retrospective automated data routinely captured within the institution's EHR. EHR time was separated into four categories: weekday work-hours in-clinic time, weekday work-hours out-of-clinic time, weekday afterhours time, and weekend/holiday after-hours time. Ordinal regression was used to determine the relationship between burnout and EHR time categories. Results EHR use during in-clinic sessions was related to burnout in both bivariate (odds ratio [OR] = 1.04, 95% confidence interval [CI]: 1.01, 1.06; p = 0.007) and adjusted (OR = 1.07, 95% CI: 1.03, 1.1; p = 0.001) analyses. No significant relationships were found between burnout and after-hours EHR use. Conclusion In this small single-institution study, physician burnout was associated with higher levels of in-clinic EHR use but not after-hours EHR use. Improved understanding of the variability of in-clinic EHR use, and the EHR tasks that are particularly burdensome to physicians, could help lead to interventions that better integrate EHR demands with clinical care and potentially reduce burnout. Further studies including more participants from diverse clinical settings are needed to further understand the relationship between burnout and after-hours EHR use.

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