Physician fatigue linked to electronic health record use

Residency Program Insider, July 29, 2020

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By Christopher Cheney, senior clinical care editor at HealthLeaders

Editor’s note: The following is an excerpt of an article appearing on HealthLeaders. Click here to view the full article.

Most physicians experience fatigue working with electronic health records (EHRs) for as little as 22 minutes, a recent research article indicates.

EHR use has been directly linked to physician burnout. For years, physicians have complained about click-intense and data-busy EHR interfaces. Excessive EHR screen time has been associated with medical errors.

The recent research article, which was published by JAMA Network Open, features data collected from 25 physicians who completed four simulated reviews of ICU patients using the Epic EHR.

“Physicians experience electronic health record-related fatigue in short periods of continuous electronic health record use, which may be associated with inefficient and suboptimal electronic health record use. … The use of electronic health records is directly associated with physician burnout. An underlying factor associated with burnout may be EHR-related fatigue owing to insufficient user-centered interface design and suboptimal usability,” the researchers wrote.

The research article features several key data points:

  • Every physician in the study experienced physiological fatigue at some point in reviewing the four simulated ICU cases with the EHR
  • 36% of the physicians experienced fatigue in the first minute of the study
  • 64% of the physicians experienced fatigue at least once in the first 20 minutes of the study
  • 80% of the physicians experienced fatigue after 22 minutes of the study
  • If a physician experienced fatigue while reviewing one simulated ICU case, the next case took more time, more mouse clicks, and more EHR screen visits to finish

The study’s findings probably underestimate the level of fatigue physicians experience when using an EHR, the researchers wrote. “When compared with a typical day in an ICU, the simulation undertested the clinical demands of a physician. First-year trainees routinely review five or more patients, while upper-level residents, fellows, and attending physicians routinely review 12 or more patients.”

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