Development of the TrendBurden Survey: Assessing Perceived Documentation Burden among Health Professionals in the United States

Elizabeth A. Sloss; Ayomide Owoyemi; Anup Kumar Mishra; Kathleen Sidwell; Shanawaz Abdul; Gigi Dawood; Matthew R. Allen; Davis Austria; Zachary Pope; Faraaz Chekeni; Sarah Corley; Aaron Grigg; Vince Hartman; Kevin B. Johnson; Deborah R. Levy; Kyle Marshall; Judy Murphy; Barry Newman; Toni Phillips; Kevin D. Smith; James Szymanski; Sarah Rossetti

doi:10.1055/a-2562-0910

Applied Clinical Informatics, Table of Contents

Appl Clin Inform 2025; 16(03): 662-675
DOI: 10.1055/a-2562-0910

Research Article

Development of the TrendBurden Survey: Assessing Perceived Documentation Burden among Health Professionals in the United States

Elizabeth A. Sloss^*

¹College of Nursing, University of Utah, Salt Lake City, Utah, United States

,

Ayomide Owoyemi^*

²Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, Illinois, United States

,

Anup Kumar Mishra

³Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States

,

Kathleen Sidwell

⁴American Medical Informatics Association, Washington, District of Columbia, United States

,

Shanawaz Abdul

⁵John Dingell VA Medical Center, Detroit, Michigan, United States

,

Gigi Dawood

⁶UW- Madison University Hospital and Clinics, Madison, Wisconsin, United States

,

Matthew R. Allen

⁷University of California San Diego, School of Medicine, La Jolla, California, United States

,

Davis Austria

⁸VA Quality Scholars Fellowship, Health Equity & Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Veterans Affairs (VA) Health Care System, Charleston, South Carolina, United States

,

Zachary Pope

⁹UC Davis Health, Sacramento, California, United States

,

Faraaz Chekeni

¹⁰Nationwide Children's Hospital, Columbus, Ohio, United States

¹¹College of Medicine, The Ohio State University, Columbus, Ohio, United States

,

Sarah Corley

¹²MITRE Corporation, McLean, Virginia, United States

,

Aaron Grigg

¹³Grande Ronde Hospital and Clinics, La Grande, Oregon, United States

,

Vince Hartman

¹⁴Abstractive Health, New York, New York, United States

,

Kevin B. Johnson

¹⁵Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States

¹⁶Applied Informatics, University of Pennsylvania Health System, Philadelphia, Pennsylvania, United States

,

Deborah R. Levy

¹⁷Department of Veterans Affairs, Amarillo VA Healthcare System, Amarillo, Texas, United States

¹⁸Department of Biomedical Informatics and Data Sciences, Yale University School of Medicine, New Haven, Connecticut, United States

,

Kyle Marshall

¹⁹Geisinger Commonwealth School of Medicine Clinical Informatics, Scranton, Pennsylvania, United States

,

Judy Murphy

²⁰Independent, Minneapolis, Minnesota, United States

,

Barry Newman

²¹Providence Health, Portland, Oregon, United States

,

Toni Phillips

²²U.S. Department of Veterans Affairs, Gainesville, Florida, United States

,

Kevin D. Smith

²³University of Chicago Medicine, Chicago, Illinois, United States

,

James Szymanski

²⁴Montefiore Medical Center/Albert Einstein School of Medicine, Bronx, New York, United States

,

Sarah Rossetti

²⁵Department of Biomedical Informatics, Columbia University Medical Center, New York, New York

› Author Affiliations

Abstract

Background

Documentation burden contributes to health professional burnout and negatively impacts health professional well-being and patient care quality. Yet, there is a gap in the literature regarding an effective measure to assess the perceived documentation burden of health professionals in a wide range of care settings over time.

Objectives

We developed and administered a pulse survey to trend, with subsequent administrations, the perceived documentation burden of health professionals in all care settings in the United States over time.

Methods

A multimethods approach was used which included conducting a scoping review of the literature to identify and then curate a set of potential survey items based on scoping review results. Next, a modified Delphi approach was used with clinical informatics experts for consensus-driven item selection and pulse survey development. Finally, we administered the pulse survey nationally using snowball sampling through professional listservs and networks of organizations.

Results

The scoping review helped to identify constructs and items to include on the pulse survey. After four iterations of the modified Delphi approach, consensus was reached on five final items for the pulse survey, labeled “TrendBurden.” The first administration of “TrendBurden” was completed by 1,253 healthcare professionals in April 2024. Most respondents (73.26%) disagreed that the time and effort spent documenting patient care is appropriate, with 77.42% reporting finishing work later or needing to work from home due to excessive documentation tasks. Seventy-four point three-eight percent agreed that the effort or time required to complete documentation tasks impedes patient care, and less than one-third (31.76%) agreed that the EHR is easy to use.

Conclusion

The “TrendBurden” Pulse Survey was developed through a scoping review of the literature and expert consensus. The resulting five-question pulse survey was administered nationally and provided insight into current perceptions of documentation burden among healthcare professionals.

Keywords

excessive documentation burden - pulse survey - electronic health record

Full Text

References

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