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Solutions to Reduce EHR Burdens and Decrease Physician Burnout

Series One: Electronic Health Records

Electronic health records (EHR) — including electronic medical records (EMR), electronic prescribing, electronic patient portals, and computerized physician order entry (CPOE) — are a main cause of physician burnout. Research has identified key aspects of EHR systems that contribute to physician burnout.

A 2016 study in the Annals of Internal Medicine addressing EHR-related physician burnout found that for every hour of direct clinical facetime with patients, doctors spent nearly two additional hours on EHR and desk work within the workday, and another one to two hours of personal time doing computer and clerical work. A 2017 NEJM Catalyst survey of Physician and healthcare executive respondents on burnout rated “increased clerical burden,” which is heavily influenced by electronic health records, as the biggest cause of burnout. A 2016 study evaluating the relationship between the electronic environment and physician burnout concluded that electronic health records have reduced efficiency, increased clerical burden and increased the risk of burnout for physicians.

10 Tips for Reducing EHR Burnout

Consider the following strategies to address stress caused by EHRs:

1. Work with IT staff to improve EHR usability

IT department staff (or vendors or consultants) can most likely improve the usability of an existing system for an individual physician. Multiple small changes to EHR usability can have a significant effect on the administrative burden caused by an EHR. Discover some EHR customization strategies that can be proposed to IT Department staff.

2. Convince administrators and physician leaders that EHR usability issues require solutions

Clinicians need to convince administrators and leadership that there is a problem with the EHR and that the problem is solvable. Many healthcare organizations are already optimizing their EHR systems to enhance clinical decision-making while alleviating physician burnout. Consider sharing these success stories.

3. Create the market force to drive a more physician–centric EHR by demanding that EHR developers and designers make systems more clinically relevant

Being forced to use poorly designed EHR systems is a major contributor to physician burnout. Luckily, EHR developers have started optimizing EHR systems. Promising technologies for focusing EHR on end-user value and usability are in development. Use these talking points and research articles to educate EHR developers and designers about clinician EHR needs.

4. Support organizations advocating for EHR clinical relevance and usability

Legislators need the wisdom and creativity of physicians to transform EHR-related legislation. Organizing for EHR change can be both strategic and therapeutic for physicians. Clinicians have many different ways to advocate for increased clinical relevance and usability in EHR systems. Consider these suggestions for jump-starting advocacy efforts to align policy and technology in ways that reduce EHR administrative burden and reorient clinical documentation toward healthcare facilitation and communication instead of billing.

5. Use a live or virtual scribe

Scribes can reduce burnout in a variety of ways, including: decreasing physician data entry requirements, decreasing feelings of isolation, and increasing physician engagement with patients. Consider these strategies for obtaining a scribe, including convincing administrators that scribes are a good financial investment.

6. Share data collection duties with others

Sharing clerical tasks can result in each team member working at the top of his or her skill set. We’ve gathered articles and other resources that discuss redesigning the clinical care model to address increased clerical burden leading to clinician burnout.

7. Develop EHR expertise

Investing time in achieving EHR proficiency can reduce frustration and increase efficiency. Research indicates that physicians with adequate EHR training are significantly more satisfied with their EHR system. One or a combination of the strategies we’ve provided can increase your EHR expertise.

8. Improve EHR patient engagement skills

The EHR system can be transformed from an intrusive burden into a patient engagement tool. Consider these strategies for using the EHR as a patient engagement tool.

9. Talk to colleagues directly

Choosing a direct conversation with a colleague over electronic communication once in a while can reduce burnout. The EHR can create a sense of social isolation. This article discusses Mayo Clinic’s program using small group meetings to encourage collegiality, shared experience, connectedness, mutual support and meaning in work, thereby promoting well-being and a reduction of burnout and distress.

10. Focus on the positive

So much is wrong with EHRs in everyday practice that it is difficult to step back and appreciate the benefits EHRs have to offer. We have collected articles and other resources that describe some exciting EHR realities and future projections.