Thanks to the federal incentive/penalty program for use of electronic medical records by providers, they have become ubiquitous. What is not yet clear is whether EHRs have more beneficial than harmful attributes. A new study in Health Affairs describes their effect on physicians. (HA Article) The authors noted the constant interaction physicians now must have with EHRs, some studies suggest as much as 50% of primary care doctors’ time is spent on the computer, and looked specifically at use of EHRs at one large multispecialty practice. They were particularly interested in EHR-generated email in-basket messages, which are responsible for a significant part of computer time. About 900 doctors participated in the study and 36% of those reported burnout symptoms and 29% said they planned to reduce clinical time in the next year. On the other hand 83% said they had good or better control of their work schedule and 60% said they had a reasonable work area. The average number of weekly in-basket messages in the EHR was 243 of which about half were generated by the EHR itself. Only 30 messages a week came from patients and 53, on average, from other doctors. But there was also wide variation in the number of messages, with many physicians receiving far more than the average. About 45% of doctors with more than the average number of messages reported burnout symptoms, suggesting some link between the two. Women seemed more prone to burnout symptoms than men. Factors associated with less reporting of burnout included feeling that doctors are highly valued, having control over the work schedule and having a calmer work environment. The results suggest that trying to reduce email messages, especially those generated by the EHR, could help with physician satisfaction. While many of these messages are well-intended, for example for reminders about recommended care for patients, you have to wonder if the doctor is the best person to deal with these. All of us probably want our clinicians to be satisfied with their jobs, because if they are satisfied, they are more likely to be attentive and caring toward patients. Fixing the issues with EHRs would go a long way toward reaching that goal.
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The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at firstname.lastname@example.org.