What Role Do EHR's Play In The Growing Issue of Physician Burnout?

The unfortunate rise of physician burnout is now a well-known fact, caused by a multitude of problems from ever-changing bureaucratic rules and regulations within the healthcare system, to the struggle to maintain work-life balance, to the increasingly long hours doctors must spend dealing with insurance companies and gaining approval to treat patients.

It’s even more troubling that electronic health records (EHRs), which are meant to be an innovative improvement in healthcare, are one of the major defining factors in physician burnout.

According to a national study by the Mayo Clinic and the American Medical Association, 44 percent of physicians who use EHRs are dissatisfied with them, and 63 percent believe EHRs make their job less efficient.

Technological advancements are generally thought of as improvements on our lives, meant to increase the convenience, productivity and efficiency of our daily proceedings. EHRs in particular were created to quicken doctor visits, reduce errors and improve patients’ care. However, since physician burnout has been linked to a decline in quality of care, an increased risk for medical errors, amongst other debilitating symptoms, it appears the implementation of EHRs has done just the opposite.

Mayo Clinic physician and lead author of the study, Tait Shanafelt, MD, explains:

“Although electronic health records, electronic prescribing, and computerized physician order entry have been touted as ways to improve quality of care, these tools also create clerical burden, cognitive burden, frequent interruptions and distraction -- all of which can contribute to physician burnout.”

The increased digitization of healthcare also decreases the amount of time physicians get to actually sit down and interact with patients in person, which is one of the core components to quality care. Instead, physicians find themselves frustrated as they spend unreasonable amounts of time inputting data and responding to messages and alerts. Chief medical officer at CareMore, Sachin Jain, MD, says, “They feel like the system is aligning to make their jobs difficult.

According to Drs. Michael Krasner and Ronald Epstein of of the University of Rochester Medical Center, the key to alleviating physician burnout is healthy interactions and relationships between medical colleagues and patients. They point out that many hospitals have begun to implement workshops on mindfulness meditation and interpersonal communication in order to reduce stress and enhance “physician resilience” on the job. But are these steps really that effective in addressing physician burnout overall?

Mark Linzer, director of the division of general internal medicine at Hennepin County Medical Center in Minneapolis says, “Burnout results from challenges within the system.” And the current system inherently inhibits the interpersonal relationships that Krasner and Epstein claim are so vital to preventing physician burnout.

The solution should not be to force physicians to adapt to a system that does not seem to be working on many levels, but to instead adapt the system to meet the needs of physicians. Tait Shanafelt explains,

We need to find ways to incorporate EHRs, patient portals and electronic order entry in a way that does not increase clerical burden for physicians or reduce their efficiency.”

This can be done by simply increasing human interaction and responsibilities, through methods such as hiring medical scribes, having nurses filter and respond to electronic information and messages for physicians, or having a human support staff, as opposed to electronic messaging, who can verbally communicate between patients and physicians.

No matter what actions are taken, the high rates of physician burnout are not going to change overnight, making it even more necessary for something, anything, to be done in an attempt to turn around this serious problem in the medical field.

Aptly named, Enclothed Cognition is the official Medelita blog for medical professionals interested in topics relevant to a discerning and inquisitive audience. Medelita was founded by a licensed clinician who felt strongly about the connection between focus, poise and appearance.

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