Physician Burnout and the Electronic Health Record Leading Up to and During the First Year of COVID-19: Systematic Review

Physician Burnout and the Electronic Health Record Leading Up to and During the First Year of COVID-19: Systematic Review

Physician burnout was first documented in 1974, and the electronic health record (EHR) has been known to contribute to the symptoms of physician burnout. Authors pondered the extent of this effect, recognizing the increased use of telemedicine during the first year of COVID-19. The aim of this revie...

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Bibliographic Details
Published in:Journal of medical Internet research Vol. 24; no. 3; p. e36200
Main Authors: Kruse, Clemens Scott, Mileski, Michael, Dray, Gevin, Johnson, Zakia, Shaw, Cameron, Shirodkar, Harsha
Format: Journal Article
Language:English
Published: Canada Journal of Medical Internet Research 31-03-2022
Gunther Eysenbach MD MPH, Associate Professor
JMIR Publications
Subjects:
Adult
Analysis
Autonomy
Bias
Burn out (Psychology)
Burnout
Burnout, Professional - psychology
Coronaviruses
COVID-19
Documentation
Electronic Health Records
Electronic records
Evidence-based medicine
Fatigue
First year
Humans
Intervention
Life control
Medical records
Medical research
Meetings
Meta-analysis
Pandemics
Patient satisfaction
Physicians
Physicians - psychology
Review
Symptoms
Systematic review
Telemedicine
Vendors
Work-Leisure conflict
cognitive fatigue
physician burnout
mental health
psychiatry
pandemic
COVID-19
medical informatics
health informatic
quality improvement
health care professional
electronic health record
health care
health care infrastructure
health care system
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Summary:Physician burnout was first documented in 1974, and the electronic health record (EHR) has been known to contribute to the symptoms of physician burnout. Authors pondered the extent of this effect, recognizing the increased use of telemedicine during the first year of COVID-19. The aim of this review was to objectively analyze the literature over the last 5 years for empirical evidence of burnout incident to the EHR and to identify barriers to, facilitators to, and associated patient satisfaction with using the EHR to improve symptoms of burnout. No human participants were involved in this review; however, 100% of participants in studies analyzed were adult physicians. We queried 4 research databases and 1 targeted journal for studies commensurate with the objective statement from January 1, 2016 through January 31, 2021 (n=25). The hours spent in documentation and workflow are responsible for the sense of loss of autonomy, lack of work-life balance, lack of control of one's schedule, cognitive fatigue, a general loss of autonomy, and poor relationships with colleagues. Researchers have identified training, local customization of templates and workflow, and the use of scribes as strategies to alleviate the administrative burden of the EHR and decrease symptoms of burnout. The solutions provided in the literature only addressed 2 of the 3 factors (workflow and documentation time) but not the third factor (usability). Practitioners and administrators should focus on the former 2 factors because they are within their sphere of control. EHR vendors should focus on empirical evidence to identify and improve the usability features with the greatest impact. Researchers should design experiments to explore solutions that address all 3 factors of the EHR that contribute to burnout. PROSPERO International Prospective Register of Systematic Reviews CRD42020201820; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=201820. RR2-10.2196/15490.
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ISSN:1438-8871
1439-4456
1438-8871
DOI:10.2196/36200