Physicians’ Well-Being Linked To In-Basket Messages Generated By Algorithms In Electronic Health Records

• Published in: Health Affairs Vol. 38; no. 7; pp. 1073 - 1078
• Main Authors: Tai-Seale, Ming, Dillon, Ellis C., Yang, Yan, Nordgren, Robert, Steinberg, Ruth L., Nauenberg, Teresa, Lee, Tim C., Meehan, Amy, Li, Jinnan, Chan, Albert Solomon, Frosch, Dominick L.
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 01.07.2019
• Subjects: Algorithms; Burnout; Computerized medical records; Electronic health records; Electronic medical records; Exercise; Gender differences; Health care delivery; Health records; Internal medicine; Leadership; Life satisfaction; Males; Medical records; Medicine; Messages; Patients; Pediatrics; Physical fitness; Physicians; Primary care; Questionnaires; Redesign; Regression analysis; Satisfaction; Signs and symptoms; Sleep; Variables; Well being; Work environment; Work life balance; Workflow; Working conditions; Workload; Workloads; work environment; Physician well-being; electronic health records; burnout
• ISSN: 0278-2715; 2694-233X; 1544-5208; 2694-233X
• DOI: 10.1377/hlthaff.2018.05509

Despite concerns about physicians' workload associated with electronic health records (EHRs), little attention has been paid to the relationship between physicians' well-being and the in-basket messages physicians receive-specifically, their volume and sources. Analyses of EHR work performed by physicians in a multispecialty practice found that in-basket messages generated by the EHR system accounted for almost half (114) of the 243 weekly in-basket messages received per physician, on average-far exceeding the numbers received from their colleagues (53) and patients (30). In a survey, 36 percent of the physicians reported burnout symptoms, and 29 percent intended to reduce their clinical work time in the upcoming year. Receiving more than the average number of system-generated in-basket messages was associated with 40 percent higher probability of burnout and 38 percent higher probability of intending to reduce clinical work time. Physicians' perceptions of a positive work environment were associated with lower odds of burnout and intention to reduce clinical work time and with greater satisfaction with life. Female physicians had a higher risk of burnout and lower satisfaction with life, compared to males. Meaningful redesign of EHR in-basket workflow and a wellness-enhancing work environment are necessary to effectively improve physicians' well-being.