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Does Increased Clerical Work Lead to Provider Burnout?

Technological advances that are designed to improve patient safety and quality of care may have the side effect of information overload, frequent interruptions/distractions, and a change in the content of professional work for healthcare providers. Specifically, electronic health records (EHRs), electronic prescribing, electronic patient portals, and computerized physician order entry (CPOE), increase the clerical burden on healthcare providers. In some cases, EHRs have been paid for by the elimination of transcription services and require healthcare providers to self-enter notes by typing or voice recognition software. These changes appear to have increased the amount of time physicians spend on documentation and other clerical tasks.

Studies suggest that more than half of US physicians are now experiencing professional burnout and that burnout is dramatically more common in physicians than in US workers in other fields. A recent study sought to evaluate current associations between the electronic environment, clerical burden, and burnout. The authors conducted a national survey of 6,500 US physicians in active practice in 2014. Physician burnout was measured using the Maslach Burnout Inventory, a validated 22-item questionnaire considered the gold standard for measuring burnout.

Physician satisfaction with their EHRs and CPOE was generally low. Physicians reported widespread dissatisfaction with the clerical burden and fewer than 30% believed the time spent on clerical tasks either directly or indirectly related to patient care were reasonable. By a greater than 2 to 1 margin, physicians disagreed with the notion that their EHRs or patient portal had improved their efficiency. Physicians who used EHRs or CPOE were at higher risk for burnout regardless of whether they were or were not satisfied with their EHRs or CPOE. CPOE seemed to be more directly responsible for burnout; physicians using CPOE had an approximately 30% higher risk of burnout after adjusting for all other factors.

The authors conclude that even though these tools show promise for enhancing coordination of care, reducing errors, and improving quality of care, in their current form and implementation they seem to have had a variety of unintended negative consequences. They suggest that innovative approaches that incorporate these electronic tools into practice without adversely affecting physician efficiency and professional satisfaction are needed.


Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: August 10, 2016

Source: Mayo Clinic
Adapted from the original article.

[Image: Pixabay / Unsplash]

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