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You have learned the benefits of Health Information Exchange. The Electronic Medical Record (EMR) is one of the basic structures in order to exchange information among different departments/organizations.
Recently, there are many reports stating that EMR is one of top leading causes of physician burnout. The article by Muhiyaddin R, et al. provided evidence of this issue.
What do you think about this finding? Have you ever heard any complaints from health officers (or yourself) on using EMR? Any suggestions to avoid or reduce this problem.
https://mu-informatics.org/wp-content/uploads/2023/09/EMR-and-Physician-burnout.pdf
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Electronic Medical Record has been a great tool for health information exchange, but it has also increased the physician burnout for the following reasons as outlined by Muhiyaddin et al. (2022). They are EHR’s poor design, increased workload such as EHR’s documentation and related tasks leading to overtime, alert fatigue. These burnouts are associated with low-quality care, career dissatisfaction resulting in the decline in patient safety and turnover.
Addition to above paper, I heard some complaints from senior health officers on using EMR. Some of the main reasons are related to the design of EMR not being user-friendly, an increase in their documentation workload, and alert fatigue. Therefore, I believe that physician burnout due to these reasons should not be ignored as it poses a barrier against patient’s outcomes as well as physician’s well-being.
To ease and reduce the burnouts of the physicians, we need to consider the following suggestions.
1. Many cited the “poor design” of the EHR as one of the leading causes of the burnouts. So, modifying the interface of the EHR as well as the workflow of the EHR that is centered on the end-users like patients and physicians (in other words, making EHR’s design more user-friendly) can improve the workflow and ease the burnouts.
2. Addition to making EHR’s design more user-friendly, it is important that we should conduct regular training sessions of EHR to improve the capacity of the physician in using EHR.
3. Another big issue is “alert fatigue”. Incessant alerts on medication refills and lab results lead to alert fatigue. To overcome this, we need to listen to the feedback of the physicians and tailored the system such as adjusting the thresholds for alerts and opting it for priority issues can ease the burnouts of the physicians.References
Muhiyaddin, R., Elfadl, A., Mohamed, E., Shah, Z., Alam, T., Abd-Alrazaq, A., & Househ, M. (2022). Electronic Health Records and Physician Burnout: A Scoping Review. Studies in health technology and informatics, 289, 481–484. https://doi.org/10.3233/SHTI210962.-
The issue of “poor design” or “not user-friendly” in the development of digital technology, particularly Electronic Medical Records (EMRs), is a significant concern that impacts both physicians and patients. Involving physicians in the design process from the beginning can enhance that the system addresses real challenges and needs.
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What do you think about this finding?
When I read this research report, I was somewhat surprised to learn that EHRs are a leading cause of physician burnout. This has implications, including increased turnover, mental health issues, and rising substance abuse. I believe this may stem from the challenges associated with transitioning to new technologies and workflows. Therefore, when implementing EHRs, it is essential to take a holistic approach, ensuring that technology does not become an added burden for users. However, the use of EHRs has more benefits for healthcare than traditional methods.Have you ever heard any complaints from health officers (or yourself) on using EMR?
I have heard about the implementation of EMRs in public hospitals, where initially there was a requirement to track and report the usage among various medical departments. They encountered issues with older physicians who were reluctant to adopt the new system. Additionally, there were policies requiring physicians to document ICD-10 codes in private hospitals, which necessitated more compensation measures for compliance.Any suggestions to avoid or reduce this problem.
To avoid or reduce this problem, here are some suggestions:
User-Friendly Design: EMR systems should prioritize user experience. Designing intuitive interfaces and simplifying workflows can significantly reduce the time and effort required to navigate these systems.
Ongoing Training and Support: Providing regular training and technical support can help physicians become more comfortable and efficient with EMR systems, reducing frustration and enhancing productivity.
Automate Documentation: Implementing tools like voice typing, predictive text, and pre-filled templates can speed up data entry, may reduce the workload, allowing physicians to focus more on patient care.
Monitor Workload: Regularly assess and manage physician workloads to ensure they are reasonable and manageable. Address any imbalances that may lead to excessive stress.
Solicit Feedback: Create channels for healthcare professionals to provide feedback about their experiences with EHRs. Use this feedback to make necessary adjustments and improvements.
Recognize and Reward: Acknowledge the hard work and dedication of healthcare professionals. Recognizing their efforts can boost morale and incentive.Implementing these strategies can help create a healthier work environment and improve the overall experience of using EHRs for healthcare providers.
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Hello Wannisa, yes, it is surprising to see that EMRs is one of the leading factors of physicians’ burnout. Among your suggestions, I believe that soliciting feedback and appreciation through recognition and rewards are part of the change management strategy to alleviate the stress and burnout related to EMR. Additionally, regular hands-on training can also improve the capacity of the old physicians.
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My first reaction to this paper is that it does not make any sense, provoking me to ask so many questions. Why are physicians required to do such responsibilities in the first place? Shouldn’t they assign to other professionals such as a Data Entry Officer? When I read the consequences of physician burnout, it is a bit of a joke that it leads to substance abuse. After reading the paper, I concluded that it is rather an HR management issue, injecting irreverent responsibilities into the role of physicians.
What do you think about this finding?
Regarding this finding, I totally agree with the causes and consequences of physician burnout. Having said that, I am curious to see how it could lead to substance abuse (probably arising from mental health issues) while others do not seem to suffer from it.
Have you ever heard any complaints from health officers (or yourself) about using EMR?
In my experience, in Myanmar, EHRs are handled by office staff. Physicians prescribe and take notes on paper. Those notes and prescriptions are digitized by office staff. Due to the EHRs, the consequences are affected on patients, not physicians. Basically, as a patient, it tests the growth of our patience. The major complaint from patients is longer waiting time and the complaints from officer staff (not physicians in this case) are the same as the consequences described in the paper.
Any suggestions to avoid or reduce this problem?
Until the causes are solved, eliminating the consequences will be ineffective or temporary with recurrences. Among six main causes, I’ll discuss four cases related to e-Health:
EHR’s documentation and related tasks: Automating documentation process with offline-capable AI model from paper records or assigning patients to record their documents in the application by themselves by prioritizing treatment first.
EHR’s poor design: There is no one-size-fits-all design that will satisfy all hospitals, clinics, and industry. The user interface cannot be defined without understanding the backbone of the operation behind it and how users will experience the use of the app design while in operation. The objective of EHR and its design should rather accelerate their operation than be a barrier to them.
Inbox alerts and alert fatigue: The system will trigger alerts in non-humane ways. The humane way is to call physicians if it is actually something very urgent, very emergent, and worth noticing. If the alerts are coming from outdoor patients, it is better to be responsible for the patients themselves. If something bad happens, as time is critical, the nearest doctors or hospitals can save lives. Additionally, the system should not handle alert-level messages but notification-level messages for physicians even if it is an emergency.
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According to the provided paper and experience in my implementation, the electronic health record/electronic medical record (EHR/EMR) is the most common cause of physician burnout. There are many facts about physician burnout. I would like to share on the EHR implementation happened to physician burnout issues.
1. EHR is provided to work from anywhere means hospitals, clinics, and health care service facilities. So the patients can access it from their smartphone or computer at anywhere and anytime. According using my pilot EHR apps in some clinics, the doctors and physicians were annoyed with much more working hours faced with the applications because of not completed design, and increased workload of paper-based documentation for further keeping process.
2. The physician or doctor isn’t friendly to the EHR UI/UX interface although our implemented apps UI/UX interface is simple. And another problem is taking responsibility for that. The developing/ implementing EHR design time needs to deal with doctors/physician their processes, and their knowledge. “Poor design” or “bad interface” can lead to time-consuming and burnout. To solve this issue, physicians utilizing the EHR need to communicate their experiences, both positive and negative, to the developers for the adaptation of the EHR platform.
3. Physicians might feel uneasy because they are focused on using EHRs instead of prioritizing their patients. The EHR can change the doctor-patient relationship differently. Some patients can accept the changes, but some are not. This can contribute to the point of leading to physician burnout.
Conclusion,
We need to emphasize that the EHR implementation should decrease working time, enhance efficiency, and make tasks easier compared to the paper-based system. And Low-quality care, behavioral issues, mental health complications, costly turnover, and patient safety and satisfaction on the EHR. In the future clinicians to deal with computer software including EMR/EHR.-
Hello Aye, you have highlighted the major issues impacting the physicians related to EHRs. Most of them feel overwhelmed by the change to a new system, and some are totally unfamiliar with technology. Additionally, poor design and lack of friendly UI further exacerbate the burden. So, like you suggested, having a user-friendly design as well as hands-on training accompanying with change management can alleviate their burnouts.
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What do you think about this finding?
This article presents evidence on the challenges of EHR utilization. However, there appears to be potential researcher bias in the literature review, and the scoping review may lack a critical appraisal. As a result, the study primarily focuses on the negative aspects of various EMR systems. A systematic review could provide a more balanced perspective by highlighting both the positive and negative findings, considering the type, complexity, and design of the EMRs.Have you ever heard any complaints from health officers (or yourself) on using EMR?
A few months ago, I conducted an impact assessment on the use of EMRs in low-resource settings. This qualitative study revealed that a significant proportion of healthcare providers face challenges in utilizing EMRs in primary care setting. These challenges contribute to the burden on the healthcare system and exacerbate the shortage of human resources for health. Key findings from the assessment include the lack of contextual relevance in EMR design, particularly in fragile and conflict settings, limited digital literacy among healthcare providers, system complexity, and the absence of interoperability between systems, such as laboratory, pharmacy, and radiology.Suggestions:
Improving user-friendliness and interoperability will be game changer in enhancing the efficient use of EMRs. Reducing the burden of data entry, especially in low-resource settings, could also be an effective strategy. Additionally, adopting the PDSA (Plan, Do, Study, Act) framework can help continuously monitor EMR utilization for quality improvement and better outcomes in its implementation.-
Hello Alex, yes, digital literacy and lack of interoperability between different departments are two of the leading causes of burden while implementing EHRs in low-resource settings. Like you suggested, PDSA model can further alleviate the burden. Additionally, providing hands-on training and regular sessions on digital and data literacy will improve the efficiency of the EHRs.
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What do you think about this finding? Have you ever heard any complaints from health officers (or yourself) on using EMR?
The findings in the document highlight significant challenges that Electronic Health Records (EHRs) pose to healthcare professionals, leading to physician burnout. This resonates with broader concerns, the causes of burnout identified, such as the overwhelming amount of time spent on documentation, poorly designed user interfaces that complicate workflows, are all issues I’ve heard echoed by health officers.
Any suggestions to avoid or reduce this problem.
To address or reduce this problem, I would suggest the following strategies:• Improved EHR Design: Simplifying the interface, reducing unnecessary steps, and making it more intuitive could ease the burden on healthcare workers.
• Task Delegation: Assigning non-clinical EHR tasks to support staff can free up physicians to focus more on direct patient care.
• Training and Ongoing Support: Offering comprehensive training on EHR usage and continued support could reduce the learning curve and alleviate some of the stress.
• Feedback Mechanisms: Regularly gathering and acting on feedback from users can lead to system improvements that are aligned with actual workflow needs. -
I think the poor design of EMRs are a critical issue contributing to physician burnout and negatively impacting patient care. To solve this, EMR systems must be redesigned with a focus on usability, simplicity, and alignment with clinical workflows. By reducing the documentation burden, minimizing alert fatigue, and encouraging a better work-life balance, healthcare systems can improve both the experience for physicians and the quality of care provided to patients.
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