Burnout Related to Electronic Health Record Use in Primary Care

Abstract

Physician burnout has been increasing in the United States, especially in primary care, and the use of Electronic Health Records (EHRs) is a prominent contributor. This review article summarizes findings from a PubMed literature search that shows the significant contributors to EHR-related burnout may be documentation and clerical burdens, complex usability, electronic messaging and inbox, cognitive load, and time demands. Documentation requirements have escalated and have inherently changed from paper-based records. Many clerical tasks have also shifted to become additional physician responsibilities. When considering factors of efficiency, effectiveness, and user satisfaction, EHRs overall have an inferior usability score when compared to other technologies. The volume and organization of data along with alerts and complex interfaces require a substantial cognitive load and result in cognitive fatigue. Patient interactions and work-life balances are negatively affected by the time requirements of EHR tasks during and after clinic hours. Patient portals and EHR messaging have created a separate source of patient care outside of face-to-face visits that is often unaccounted productivity and not reimbursable.

Keywords: burnout; electronic health record; electronic medical record.

Figure 1.

Prevalence of at least one symptom of burnout among U.S. physicians. Source: From Shanafelt et al.

Figure 2.

Physician views on EHR use. (a) Gardner et al. (b) The Harris Poll.

Figure 3.

Summary of literature search.