Physician stress and burnout: the impact of health information technology

Journal of the American Medical Informatics Association - Tập 26 Số 2 - Trang 106-114 - 2019
Rebekah Gardner1,2, Emily Cooper2, Jacqueline Haskell2, Daniel A. Harris3,2, Sara Poplau4, Philip J Kroth5, Mark Linzer6
1Department of Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
2Healthcentric Advisors, Providence, Rhode Island, USA
3Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
4Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA
5Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
6Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA

Tóm tắt

Abstract Objective To quantify how stress related to use of health information technology (HIT) predicts burnout among physicians. Methods All 4197 practicing physicians in Rhode Island were surveyed in 2017 on their HIT use. Our main outcome was self-reported burnout. The presence of HIT-related stress was defined by report of at least 1 of the following: poor/marginal time for documentation, moderately high/excessive time spent on the electronic health record (EHR) at home, and agreement that using an EHR adds to daily frustration. We used logistic regression to assess the association between each HIT-related stress measure and burnout, adjusting for respondent demographics, practice characteristics, and the other stress measures. Results Of the 1792 physician respondents (43% response rate), 26% reported burnout. Among EHR users (91%), 70% reported HIT-related stress, with the highest prevalence in primary care-oriented specialties. After adjustment, physicians reporting poor/marginal time for documentation had 2.8 times the odds of burnout (95% CI: 2.0–4.1; P < .0001), compared to those reporting sufficient time. Physicians reporting moderately high/excessive time on EHRs at home had 1.9 times the odds of burnout (95% CI: 1.4–2.8; P < .0001), compared to those with minimal/no EHR use at home. Those who agreed that EHRs add to their daily frustration had 2.4 times the odds of burnout (95% CI: 1.6–3.7; P < .0001), compared to those who disagreed. Conclusion HIT-related stress is measurable, common (about 70% among respondents), specialty-related, and independently predictive of burnout symptoms. Identifying HIT-specific factors associated with burnout may guide healthcare organizations seeking to measure and remediate burnout among their physicians and staff.

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