Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Feb;21(e1):e100-6.
doi: 10.1136/amiajnl-2013-001875. Epub 2013 Sep 4.

Electronic medical records and physician stress in primary care: results from the MEMO Study

Stewart Babbott  1 , Linda Baier Manwell, Roger Brown, Enid Montague, Eric Williams, Mark Schwartz, Erik Hess, Mark Linzer
Affiliations

Electronic medical records and physician stress in primary care: results from the MEMO Study

Stewart Babbott et al. J Am Med Inform Assoc. 2014 Feb.

Abstract

Background: Little has been written about physician stress that may be associated with electronic medical records (EMR).

Objective: We assessed relationships between the number of EMR functions, primary care work conditions, and physician satisfaction, stress and burnout.

Design and participants: 379 primary care physicians and 92 managers at 92 clinics from New York City and the upper Midwest participating in the 2001-5 Minimizing Error, Maximizing Outcome (MEMO) Study. A latent class analysis identified clusters of physicians within clinics with low, medium and high EMR functions.

Main measures: We assessed physician-reported stress, burnout, satisfaction, and intent to leave the practice, and predictors including time pressure during visits. We used a two-level regression model to estimate the mean response for each physician cluster to each outcome, adjusting for physician age, sex, specialty, work hours and years using the EMR. Effect sizes (ES) of these relationships were considered small (0.14), moderate (0.39), and large (0.61).

Key results: Compared to the low EMR cluster, physicians in the moderate EMR cluster reported more stress (ES 0.35, p=0.03) and lower satisfaction (ES -0.45, p=0.006). Physicians in the high EMR cluster indicated lower satisfaction than low EMR cluster physicians (ES -0.39, p=0.01). Time pressure was associated with significantly more burnout, dissatisfaction and intent to leave only within the high EMR cluster.

Conclusions: Stress may rise for physicians with a moderate number of EMR functions. Time pressure was associated with poor physician outcomes mainly in the high EMR cluster. Work redesign may address these stressors.

Keywords: electronic medical records; outpatient clinics; physicians; primary care; stress, psychological.

PubMed Disclaimer

Figures

Figure 1
Figure 1
EMR functions from the clinic managers’ survey displayed with the probability of the functions in each cluster.
Figure 2
Figure 2
Stress scored on five-point scale, ≥3 defined as ‘stressed’; Satisfaction scored on five-point scale, ≥3 defined as ‘satisfied’; Burnout scored on five-point scale, ≥3 defined as ‘burned out’; Intent to leave scored on five-point scale, ≥3 defined as ‘likely to leave’.
See this image and copyright information in PMC

References

    1. DesRoches CM, Campbell EG, Rao SR, et al. Electronic health records in ambulatory care—a national survey of physicians. N Engl J Med 2008;359:50–60 - PubMed
    1. Hsiao CJ, Hing E. Use and Characteristics of Electronic Health Record Systems Among Office-Based Physician Practices: United States, 2001–2012. NCHS Data Brief, No 111 Hyattsville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 2012
    1. O'Malley AS, Grossman JM, Cohen GR, et al. Are electronic medical records helpful for care coordination? Experiences of physician practices. J Gen Intern Med 2010;25:177–85 - PMC - PubMed
    1. Holden RJ. Cognitive performance-altering effects of electronic medical records: an application of the human factors paradigm for patient safety. Cogn Technol Work 2011;13:11–29 - PMC - PubMed
    1. Beasley JW, Wetterneck TB, Temte J, et al. Information chaos in primary care: implications for physician performance and patient safety. J Am Board Fam Med 2011;24:745–51 - PMC - PubMed

Publication types