Study Shows Physician Burnout Directly Related to EHRs

Forty percent of physician burnout is attributable to EHRs, up from the previously estimated 13 percent.

EHRs are largely to blame for the physician burnout and stress epidemic that runs rampant in the medical industry, according to a group of researchers from the University of New Mexico (UNM).

In the past, research has shown that about 13 percent of physician self-reported levels of stress and burnout were directly correlated to EHRs.

However, Philip Kroth, MD, director of Biomedical Informatics Research at UNM, disagrees with that percentage. According to his survey, clinical process design and the clinical structure, both of which are highly impacted by EHRs, contribute to approximately 40 percent of clinician stress.

“We are losing the equivalent of seven graduating classes of physicians yearly to burnout and, as they leave the profession, they point their finger at the time now required for them to document their work and how it has led to the loss of quality time spent with patients and families,” Kroth explained.

“In many ways, physicians are finding that the goals of a traditional medical record have been hijacked,” he said. “And, while there is a great deal of research interest in physician burnout, we believe we are the first investigators who have been able to measure and correlate these impacts.”

UNM teamed up with Stanford University, University of Minnesota, Hennepin County Medical Center, and the Centura Health System in Colorado and Texas to survey 282 clinicians on EHR’s impact on stress and burnout. On top of the survey, the researchers were able to include validated measures of stress, burnout, and even the likelihood of leaving medicine.

“A medical record used to be a few lines to document a patient’s history,” Kroth said. “Until I was 18, my entire pediatric medical record was one page long.”

But when the Health Information Technology for Economic and Clinical Health (HITECH) Act was signed in 2009, EHRs were supposed to make paperwork easier, lead to more cost-effective healthcare, and reduce paper waste.

Ten years later, the survey shows that the time set aside to medical record-keeping has doubled. Physicians now spend two minutes at the computer for every one minute spent with patients, and the workdays have extended into the physicians’ homelives.

“We went to school to see patients, but now, for every minute we have with a patient, we are spending two additional minutes on the computer,” Kroth explained. “It often takes a 60-hour week just to keep up with documentation, and that is tough on personal relationships and families.”

However, the survey was not completely negative and Kroth acknowledged there are some benefits to EHR use.

“People in the focus groups liked having the ability to access and update patient medical records at home – but disliked how that access makes it easy to spend hours to update them,” he said.

EHRs also protect against potential medical malpractice, are better for billing purposes, and are a positive for quality assurance initiatives. The government also possesses the power to oversee the EHR processes.

“Physicians are being asked to do more and more – sometimes to the detriment of the physician-patient relationship,” Kroth said. “With electronic notes what should be face-to-face time with the patient is instead has turned into face-to-screen to face time.”

The survey was conducted because of a prior focus group study that identified EHRs as a reason for physician stress and burnout. This survey was based on previously validated questions that measure the stress and burnout of the respondents at the same time.

“If you thought all this data entry was meaningful and making some sort of positive patient impact then it would be a completely different story,” Kroth concluded. “But to date there has been no research showing an overall reduction in mortality, improvement in quality of life or reduced hospital admissions.”

(Note from your Revenue Cycle Management partner at ebix, Inc. – We are always at the forefront of industry insights and believe this article from Christopher Jason, for EHR Intelligence, September 2019 will be of interest to you.)