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Electronic Health Records Contribute To Major Burnout And Stress For Doctors

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Most doctors tend to work longer hours in order to fulfill duties compared with the rest of the population.

Past research has shown, however, that 40 percent of this work is not allotted for direct patient care, but for ancillary services, including paperwork.

Now, a new study has found that physicians who use order entry software and electronic health records (EHR) tend to become less satisfied on clerical tasks and more likely to get stressed out than their peers.

The Use Of EHR

Dr. Tait Shanafelt of the Mayo Clinic says EHR give doctors access to medical records even when they are at home, which technically extends the work hours.

He says studies have revealed that physicians spend more than 10 hours a week interacting with EHR even after they go home from the office, often doing so at night and during weekends.

Dr. Ann O'Malley of Washingon D.C., who was not involved in the new study, told Reuters that EHR focus on documentation for billing contrary to effective and efficient documentation of clinical care.

This means that EHR are actually less useful for direct patient care, which makes it frustrating for doctors, says O'Malley.

Major Physician Burnout

Shanafelt and his colleagues at the Mayo Clinic in Minnesota examined survey responses gathered in 2014 from doctors in the United States in all specialties. About 6,880 were involved in the survey, including 6,560 doctors who were active in practice.

More than 80 percent of the participants said they used EHR, while a similar proportion said they used computerized physician order entry (CPOE), which allows them to enter medication orders electronically.

After taking into account factors such as work hours per week and practice setting, researchers found that 33 percent of doctors who used both EHR and CPOE were displeased with how much time they spend just on clerical tasks. These doctors faced a 29 percent higher risk of burnout compared with their peers, researchers said.

The Old And The New

Unfortunately, physician burnout tends to decrease the quality of care and increase the likelihood of committing medical errors, says Shanafelt.

Dr. Ted E. Palen, who was not part of the study, says healthcare is often compared with the airline industry.

"We don't want pilots stressed out," says Palen. "We want them at their best ability." The same idea applies for doctors.

Palen says EHR are not necessarily the cause of major physician burnout. He says that in his experience, these tools make physicians more productive because they can manage more patients at a time.

He says the old paper-based workflow had more lag time and was more disjointed.

Meanwhile, O'Malley says the findings of the study means that EHR vendors need to work much more closely with doctors, nurses and staff to better understand how to make the tools more clinically relevant and user-friendly.

Details of the study are issued in the Mayo Clinic Proceedings.

Photo: Yuya Tamai | Flickr

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