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. 2017 Jul 5;8(3):686-697.
doi: 10.4338/ACI-2017-01-RA-0003.

Electronic Health Record Alert-Related Workload as a Predictor of Burnout in Primary Care Providers

Megan E Gregory  1 , Elise Russo, Hardeep Singh
Affiliations

Electronic Health Record Alert-Related Workload as a Predictor of Burnout in Primary Care Providers

Megan E Gregory et al. Appl Clin Inform. .

Abstract

Background: Electronic health records (EHRs) have been shown to increase physician workload. One EHR feature that contributes to increased workload is asynchronous alerts (also known as inbox notifications) related to test results, referral responses, medication refill requests, and messages from physicians and other health care professionals. This alert-related workload results in negative cognitive outcomes, but its effect on affective outcomes, such as burnout, has been understudied.

Objectives: To examine EHR alert-related workload (both objective and subjective) as a predictor of burnout in primary care providers (PCPs), in order to ultimately inform interventions aimed at reducing burnout due to alert workload.

Methods: A cross-sectional questionnaire and focus group of 16 PCPs at a large medical center in the southern United States.

Results: Subjective, but not objective, alert workload was related to two of the three dimensions of burnout, including physical fatigue (p = 0.02) and cognitive weariness (p = 0.04), when controlling for organizational tenure. To reduce alert workload and subsequent burnout, participants indicated a desire to have protected time for alert management, fewer unnecessary alerts, and improvements to the EHR system.

Conclusions: Burnout associated with alert workload may be in part due to subjective differences at an individual level, and not solely a function of the objective work environment. This suggests the need for both individual and organizational-level interventions to improve alert workload and subsequent burnout. Additional research should confirm these findings in larger, more representative samples.

Keywords: Electronic health records; burnout; health information technology; safety; workload.

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Conflict of interest statement

Conflict of Interest The authors report no conflict of interest in this research.

Figures

None
Fig. 1 Multiple regression of subjective and objective alert workload on the three dimensions of burnout, controlling of organizational tenure. Note: Numbers represent standardized beta-weights. * p < 0.05
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Grants and funding

Funding The research reported here was supported in part by the U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, Office of Academic Affiliations, Health Professions Education Evaluation and Research Advanced Fellowship and in part by Center for Innovations in Quality, Effectiveness and Safety (CIN 13–413), Michael E. DeBakey VA Medical Center, Houston, TX.