US hospitals get an 'F' in EHR usability due to physician burnout

por John R. Fischer, Senior Reporter | November 19, 2019
Health IT
A new survey has found a correlation between
physician burnout and poor EHR usability
A new survey has handed out mostly Fs to U.S. hospitals and physician offices in its description of the usability of their EHR systems.

The basis of these poor grades is the result of a connection found between EHR systems and physician burnout, with doctors rating the usability of their solutions in a way that was “independently associated with the odds of burnout,” according to the authors, who were made up of professional satisfaction experts from the American Medical Association, and burnout researchers from Yale, Stanford and Mayo Clinic.

“Medicine is only becoming more complex with more advanced diagnostic and therapeutic options. Adding precision medicine and the emerging field of artificial intelligence in medicine to existing EHRs could add undue stress and burnout to physicians,” Edward Melnick, assistant professor of emergency medicine and program director of the Yale-VA Clinical Informatics Fellowship Program, told HCB News. “If we don't begin to improve the EHR user experience, I believe that it will delay the availability of these emerging advances to patients.”
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Close to half of American physicians experience at least one symptom of physician burnout, which can lead doctors to cut back on clinical care, and pursue nonclinical career opportunities within medicine or outside of it. These changes contribute to the physician shortage in the U.S. and lead to access-to-care problems. EHRs, the authors say, take up as much as two hours of physicians’ time for every one hour they spend tending to patients.

Surveying nearly 900 doctors, the team awarded one point boosts in EHR usability for every three percent dip in the odds of a physician experiencing burnout. Measurements were completed through the Maslach Burnout Inventory, on a zero-to-100 scale of usability.

The average product score in usability is 68 across industries, though only 15.8 percent of doctors surveyed rated their EHR that high. Previous research shows that Google search has a usability of 93 out of 100, while Microsoft Excel, the worst-performing everyday software product, has a score of 57. The score for Excel was almost a dozen points higher in usability than the average score for EHRs, which was 45.9.

While usability and burnout strongly correlated with one another, an exact cause could not be determined, due to the cross-sectional nature of the data. The study addressed the overall state of EHR usability. Current viability variability in EHR use across healthcare systems and vendors was mixed, with certain tasks holding an average ninefold difference in time and eightfold difference in clicks between different implementations of the same EHR solution and across systems designed by different vendors.

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