Associations of physician burnout with organizational electronic health record support and after-hours charting

Abstract

In 2017, 43.9% of US physicians reported symptoms of burnout. Poor electronic health record (EHR) usability and time-consuming data entry contribute to burnout. However, less is known about how modifiable dimensions of EHR use relate to burnout and how these associations vary by medical specialty. Using the KLAS Arch Collaborative's large-scale nationwide physician (MD/DO) data, we used ordinal logistic regression to analyze associations between self-reported burnout and after-hours charting and organizational EHR support. We examined how these relationships differ by medical specialty, adjusting for confounders. Physicians reporting ≤ 5 hours weekly of after-hours charting were twice as likely to report lower burnout scores compared to those charting ≥6 hours (aOR: 2.43, 95% CI: 2.30, 2.57). Physicians who agree that their organization has done a great job with EHR implementation, training, and support (aOR: 2.14, 95% CI: 2.01, 2.28) were also twice as likely to report lower scores on the burnout survey question compared to those who disagree. Efforts to reduce after-hours charting and improve organizational EHR support could help address physician burnout.

Keywords: Pajama time; electronic medical record; emotional exhaustion; health information technology; optimization; usability.

Figure 1.

Associations between 5 hours or fewer of weekly after-hours charting and lower levels of self-reported physician burnout.^†*Significant at P < .05 **Significant at P < .001 ***Significant at P < .0001 ^† Self-reported burnout was measured using a 5-point scale from completely burned out to no burnout with a positive odds ratio indicating lower levels of burnout. Note: Physician specialties with <300 respondents and physicians who did not indicate a specialty were included in the overall analysis but excluded from specialty analyses.

Figure 2.

Associations between perceived organizational EHR support and lower levels of self-reported physician burnout.^† *Significant at P < .05 **Significant at P < .001 ***Significant at P < .0001 ^† Self-reported burnout was measured using a 5-point scale from completely burned out to no burnout with a positive odds ratio indicating lower levels of burnout. Note: Physician specialties with <300 respondents and physicians who did not indicate a specialty were included in the overall analysis but excluded from specialty analyses.