Difference between revisions of "EHR Usability and Physician Burnout"

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Melnick et al. defines usability as “the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use”. 1
 
Melnick et al. defines usability as “the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use”. 1
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A significant increase in EHR use since the 2009 Health Information Technology for Economic and Clinical Health Act has also led to an increase in professional dissatisfaction and burnout among physicians. The correlation has been attributed to many different aspects of EHR use but they generally boil down to lack of EHR usability faced by physician end-users. 1, 3
 
A significant increase in EHR use since the 2009 Health Information Technology for Economic and Clinical Health Act has also led to an increase in professional dissatisfaction and burnout among physicians. The correlation has been attributed to many different aspects of EHR use but they generally boil down to lack of EHR usability faced by physician end-users. 1, 3
  

Revision as of 01:58, 22 October 2021

Electronic Health Record usage is associated with lower physician job satisfaction and physician burnout as a result of poorly designed user interfaces and low usability.

Background

Melnick et al. defines usability as “the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use”. 1

A significant increase in EHR use since the 2009 Health Information Technology for Economic and Clinical Health Act has also led to an increase in professional dissatisfaction and burnout among physicians. The correlation has been attributed to many different aspects of EHR use but they generally boil down to lack of EHR usability faced by physician end-users. 1, 3

EHR Usability

EHR usability was quantified by Melnick et al. using the System Usability Scale (SUS). The SUS consists of 10 questions on a 5-point Likert scale with scores from Strongly Disagree to Strongly Agree. The SUS was completed by a random 870 physicians participating in a larger EHR survey sent out by Melnick et al. Physicians from across all different specialties were invited to participate in the survey and the SUS scores were adjusted to fit on a scale from 0-100 with higher scores indicating higher usability. 1

EHR usability variation was seen between different specialties with anesthesiology and general pediatrics having the highest usability scores and dermatology, orthopedic surgery, and general surgery having the lowest scores. SUS scores also varied by practice location. Those who worked in an academic medical center rated their EHR lower and those working in a veterans’ administration hospital rated their EHR higher. On average, the EHR was scored at 45/100 on the SUS giving it a grade of F and placing it well behind other commonly used systems including Excel, GPS, and Word. 1

EHR Usability and Physician Burnout

Melnick et al. found a correlation between the SUS scores and physician burnout rates. Professional burnout was measured using the Maslach Burnout Inventory (MBI) and physicians were considered to be suffering from burnout if they had high scores on the depersonalization and/or emotional exhaustion subscales of the MBI with scores greater than or equal to 27 and greater than or equal to 10 respectively. As SUS scores increased, the odds of burnout decreased; a single point higher on the SUS score was associated with 3% lower odds of professional burnout. 1

Discussion

Shortly after this article was published, Melnick et al. went on to find that factors other than EHR usability contribute to physician burnout. While the EHR is included in this “perceived task load,” it is not the sole cause of high task load and physician burnout. Perceived task load includes factors such as age, gender, medical specialty, hours worked per week, number of nights on call per week, and practice setting. Melnick et al. determined that all of these factors contribute to physician workload. Based on the authors’ findings, decreasing overall perceived task load would lead to lower physician burnout. EHR usability may not be the sole cause of physician burnout but certainly contributes to physicians’ daily workload. 2

Sources

  1. Melnick ER, Dyrbye LN, Sinsky CA, et al. The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians. Mayo Clinic proceedings. 2020;95(3):476-487. doi:10.1016/j.mayocp.2019.09.024
  2. Melnick ER, Harry E, Sinsky CA, et al. Perceived Electronic Health Record Usability as a Predictor of Task Load and Burnout Among US Physicians: Mediation Analysis. Journal of medical Internet research. 2020;22(12):e23382. doi:10.2196/23382
  3. Tajirian T, Stergiopoulos V, Strudwick G, et al. The Influence of Electronic Health Record Use on Physician Burnout: Cross-Sectional Survey. Journal of medical Internet research. 2020;22(7):e19274. doi:10.2196/19274


Submitted by Marie Pelzer