In the 2020 Medscape Emergency Medicine Lifestyle, Happiness & Burnout Report, only 25% of Emergency Physicians surveyed were “very or extremely happy at work.” [i] The same report had 43% of physicians state that they felt burned out or both burned out and depressed. Burnout not only impacts the lives of physicians, but it also has been shown to affect the quality of care. For health care organizations, physician burnout can cause reputational damage and impact the bottom line. To reduce physician burnout, we must seek to understand all the contributing factors. The impact of the Hospital Electronic Health Record (EHR) that is implemented in the ER is a factor that cannot be ignored.
The influence of physician burnout is far-reaching. It impacts not only the physician but also those around them. Physicians can exhibit negative attitudes and a lack of empathy towards staff and their patients. Studies have also found a direct correlation between physician burnout and significant medical errors.[ii] For healthcare organizations, this can have a negative impact on the bottom line due to reputational damage, lawsuits, and high physician turnover.
There is a long list of potential causes of Emergency Medicine burnout, and the hospital EHR does not escape from shouldering some of the blame. In the Medscape report, 33% of physicians chose the EHR as a contributing factor. The top contributor at 47% was “Too many bureaucratic tasks (e.g., charting, paperwork),” which have become increasingly linked to the EHR. Perhaps more concerning is that in 2020, the percentage of physicians choosing the EHR as a contributing factor has grown 22% since 2018 and 2019. (Scores are 27% in 2018[iii], 27% in 2019[iv], and 33% in 2020)
Over the past 5-10 years, we have seen a steady migration from highly specialized “Best of Breed” computer systems replaced in favor of the single integrated EHR. While these systems are adequate, their adequacy is often defined by their ability to comply with regulatory requirements and optimize the revenue cycle. In contrast, “Best of Breed” solutions are often built by end-users seeking to use innovation to improve the clinician and patient care experience. Has our acceptance of the generic EHR in high acuity specialty environments like the Emergency Room gone too far? If you could invest in systems that improved the care experience and mitigated physician burnout, would that be a good investment?
[i ] Medscape Emergency Medicine Lifestyle, Happiness & Burnout Report (Note: a free user account is necessary to access this content)
[iii] Medscape Emergency Medicine Physician Lifestyle Report 2018 (Note: a free user account is necessary to access this content)
[iv] Medscape Emergency Medicine Physician Lifestyle Report 2019 (Note: a free user account is necessary to access this content)