Use of multifunctional electronic health records and burnout among primary care nurse practitioners

J Am Assoc Nurse Pract. 2021 Jan 27;33(12):1182-1189. doi: 10.1097/JXX.0000000000000533.


Background: Prevalence of electronic health records (EHRs) has significantly increased, and EHRs are a known contributor to clinician burnout. However, it is unknown whether the use of multifunctional EHRs is associated with nurse practitioner (NP) burnout in primary care practices. This is a major gap in the literature because 69% of practicing NPs deliver primary care services to patients.

Purpose: This study aimed to investigate whether the use of multifunctional EHRs is associated with primary care NP burnout.

Method: This study is a secondary analysis of cross-sectional survey data collected from NPs in two states (Pennsylvania and New Jersey). Nurse practitioners completed surveys measuring burnout, use of multifunctional EHRs, demographics, and characteristics of their practice. Use of multifunctional EHRs was operationalized using two items-computerized capabilities and electronic reminder systems. Burnout was measured using a validated, single item asking NPs to self-report their feelings of burnout. A multilevel cox regression model was built to test for associations between the use of multifunctional EHRs and NP burnout.

Results: Of 396 NPs included, 25.3% reported burnout. The use of multifunctional EHRs did not increase primary care NP burnout (risk ratio = 0.30, 95% confidence interval = 0.13-0.71, p = .01).

Implications for practice: With 25.3% of NPs burned out, it is imperative to reduce NP burnout. However, computerized capabilities and electronic reminder systems did not contribute to feelings of NP burnout. Future research examining other EHR components is needed to understand which features of the EHR contribute to NP burnout.

MeSH terms

  • Burnout, Professional*
  • Cross-Sectional Studies
  • Electronic Health Records
  • Humans
  • Nurse Practitioners*
  • Primary Health Care
  • Surveys and Questionnaires