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EHR Work Associated With Clinician Burnout Across Specialties

A study found that a “pooling” system to triage patient portal messages did not reduce the odds of clinician burnout from EHR work.

Perceived EHR work stress was significantly associated with clinician burnout across all specialties, according to a study published in JAMIA.

Researchers invited attending physicians at UC San Diego Health System to participate in a survey in April 2020.  

Interestingly, the study found that physicians that used a pool of support staff to screen and triage patient MyChart messages were not associated with lower odds of burnout compared to physicians directly receiving MyChart messages.

“We must caution against prematurely concluding that pools are not helpful, however,” the study authors noted. “Additional research is needed to examine the availability of pools, the decision to use pools, and the qualifications, complexity of the message, and staffing mix (eg, medical assistants, registered nurses, or advance practice providers) of pool members.”

Anecdotal accounts from attending physicians suggested that some pool members forward most of the messages directly to physicians without taking additional action, diminishing the value of some pools in reducing EHR workload.

The study also found that prescription authorization message volumes were linked with higher odds of clinician burnout, highlighting the need for additional physician support.

“Within their scope of practice, using pharmacists or pharmacy assistants for these tasks has been documented to make a difference,” the authors wrote.

Additionally, the survey results found high odds of burnout among physicians who did not feel valued and who perceived their values were not aligned with those of their leaders.

“These findings are consistent with the literature showing that while EHR stress is one significant factor associated with burnout, it is not the only meaningful factor,” the researchers emphasized. “Since the CMS and other regulators and payers have modified multiple long-standing policies, including simplifying documentation requirements for billing, future research should examine the impact of these policy changes on physician wellbeing within the context of other organizational factors.”

The authors noted that to the extent possible, prescription authorization can be delegated to staff with appropriate scope of practice to reduce physicians’ EHR workload.

Additionally, since physicians in all specialties reported burnout, the researchers noted that is important to include both ambulatory care physicians and other specialists in clinician burnout studies and in the development of solutions.

“To gain better understanding of the relationship between EHR-based work and burnout, we need to use objective EHR work measures that are not limited to ambulatory care physicians,” the authors emphasized.

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