Are EHR Capabilities Contributing to Physician Burnout?

Sarasota, FL (WorkersCompensation.com) – Healthcare as a whole is on the brink of even more major changes in an effort to meet the demand in the midst of short staffing. With already unprecedented levels of burnout reported, a recent study suggests technological advances in workflow could be a potential driver of provider stress. 

Healthcare executives and physicians have already reported being overwhelmed in new software choices and integration in their rush to adopt new technology to handle the latest demand. According to a recent Healthleaders report, C-suite executives are stressed by their software system’s inability to integrate with their other platforms, resulting in increased workflow and complexity. 

Nearly 60 percent of healthcare systems are using 50 workflow points to manage their practice. Additionally, at least a quarter require 150 workflow points to get the job done. Eighty-eight percent of healthcare executives state that their software’s inability to work with other platforms has resulted in increased workloads and job complexities, as well as challenges in patient care, and increased stress and burnout among workers. Additionally, executives state that they have lost revenue and opportunities to save on costs. 

Since the start of electronic health record (HER) requirements, one of the key elements in workflow, especially if systems do not flow seamlessly, has been the inbox or inbasket messaging system. Inbasket messages are essentially tasks that have been routed to the physician and may include questions or additional information that needs to be reviewed in the process of caring for the patient. With the recent integration of patient portals, which allows the patient to send questions and receive information directly, the volume of such messages continues to grow.

According to one 2019 study, physicians were assigned 243 inbasket messages per week. According to another study from the American Medical Association in 2021, primary care physicians received an average of 49.3 messages per day. Specialists received 33.4 message per day, and surgeons received 20.7 per day. During the midst of the pandemic, the total was 45 to 46 per day for primary care physicians. Specialist totals jumped from 29.3 to 32 per day, and surgeons increased from 16.6 to 23.3 per day. 

In a recent study from researchers at the University of California, at least some of these software issues and additional workflows could be contributing at least in part to physician burnout. The researchers analyzed inbasket messages in detail and asked the question if the volume and characteristics of the messages were associated with physician burnout. 

The researchers analyzed messages from 609 physicians. A total of 1,453,245 messages were reviewed, of which 630,828 were from patients, equating to 43.3 percent. Of those messages that were classified as negative, common words included medical conditions, but also profanity and words related to violence. 

Physicians that reported burnout received a greater number of patient messages, an average of 1,230 compared to 1,142.9. Approximately half the messages received in both the burnout group and non-reported burnout group were positive. Only 5 percent of messages for both groups was classified as negative. Researchers also noted that the level of burnout was higher among Hispanic physicians and women, but significantly lower among those physicians in practice for more than 15 years. 

While the researchers admit there are limitations of the study due to timing and scope, they believe the study provides an opportunity for practices to review their overall workflows for volume, and implement message filter systems to mitigate burnout among physicians.  

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