Electronic Health Record Burden Among Gastroenterology Providers in a Large Tri-state Tertiary Referral Center

Abstract

Purpose: Electronic health record (EHR) use has resulted in new demands on providers, contributing to burnout. The EHR burden of gastroenterology (GI) providers is not well understood.

Methods: EHR use data were retrospectively collected for GI providers from three tertiary referral centers during a 1-year period. Measures included overall time in the EHR including outside regular hours and performing specific activities (clinical review and in-basket) as well as quantification of efficiency, messaging, and documentation. A survey of EHR use, perceived burden, and burnout was distributed to providers. EHR burden was compared across provider gender, training, and subspecialty on a per appointment basis.

Results: EHR use of 347 providers over 31,000 clinic days and 170,000 appointments was analyzed with additional survey data from 95 providers. Female providers had more EHR time per appointment than males, longer documentation per appointment, and more time per completed in-basket message. Non-physician providers (NPPs) spent more EHR time per appointment than physicians including more time in clinical review and per in-basket message. Comparing subspecialty, hepatologists, IBD providers, and motility specialists had the most EHR time per appointment including more time in clinical review and outside scheduled hours with IBD and motility specialists receiving more patient advice messages per appointment. Survey results showed in-basket and documentation were the top stressors with over 30% of respondents reporting burnout.

Conclusion: Higher EHR burden was noted among hepatology, IBD, and motility specialists and NPPs with in-basket messages and documentation as key stressors. More work is needed to combat factors contributing to burnout.

Keywords: Burnout; Electronic health record; Hepatology; Inflammatory bowel disease (IBD); Motility.