Doctors give their EHRs an F for usability

Dive Brief:

Doctors give their EHR systems an F for usability, according to a study conducted by Stanford and the Mayo Clinic in collaboration with the American Medical Association.
The survey of almost 5,200 U.S. doctors published Wednesday also found that worse functioning EHRs were correlated with higher reported levels of physician burnout.
It's yet another study showing the effect that poorly designed software has on doctors' day-to-day experiences, though it's important to note that numerous other workplace factors like a chaotic hospital atmosphere and lack of control also contribute to depressed and stressed out physicians.

Dive Insight:

Physician burnout is a systemic issue in American healthcare, with roughly half of the profession reporting persistent emotional exhaustion and depersonalization by some estimates. Though many factors contribute to the phenomenon, a majority of physicians blame bureaucratic demands like charting and excessive EHR input as the largest contributor.

"The findings will not come as a surprise to anyone who practices medicine," AMA President Patrice Harris said in a statement. "Too many physicians have experienced the demoralizing effects of cumbersome EHRs that interfere with providing first-rate medical care to patients."

For each point physician-rated EHR usability improved, the odds of physician burnout declined by 3%, the research published in Mayo Clinic Proceedings found. And poor EHR design and functionality doesn't only affect clinicians — a PLOS One report published in February found it also harms care coordination and risks patient safety.

Rebecca Pifer/Healthcare Dive, data from Mayo Clinic Proceedings

EHR usability varied widely by specialty, with the professions of anesthesia and pediatrics seeing the best usability and dermatology, orthopaedics and general surgery reporting the poorest.

Interestingly, some specialties at a high risk for burnout like neurology and emergency medicine rated the performance of their EHRs better than their less-burned-out peers, implying the relationship between usability and burnout "may be more than burned out physicians rating their EHR poorly," study author Ted Melnick said. Melnick called for more research on the topic.

Despite the gray areas, doctors are rarely getting help. According to Medscape, though 15% of physicians report depression and suicidal thoughts, only 43% said they'd spoken to someone about those ideations, and only one-third went to a licensed therapist.

And beyond the health effects on America's shrinking doctor population, there's also a harsh bottom line impact: Burnout costs health systems and hospitals up to $1.7 billion annually in turnover, lost productivity and medical errors.

Providers such as the Cleveland Clinic and Stanford Medicine have increasingly created roles at the C-suite level to address the situation and look at ways to integrate EHRs into doctor workflows without creating undue burden or impeding team communication. CMS is attempting to address the issue in its Patients over Paperwork initiative.