CC BY-NC-ND 4.0 · Appl Clin Inform 2018; 09(02): 336-347
DOI: 10.1055/s-0038-1648222
Research Article
Schattauer GmbH Stuttgart

Focus Section on Health IT Usability: Perceived Burden of EHRs on Physicians at Different Stages of Their Career

Saif Khairat
1  Carolina Health Informatics Program, University of North Carolina, Chapel Hill, North Carolina, United States
2  School of Nursing, University of North Carolina, Chapel Hill, North Carolina, United States
,
Gary Burke
3  Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina, United States
,
Heather Archambault
4  Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, United States
,
Todd Schwartz
4  Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, United States
,
James Larson
3  Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina, United States
,
Raj M. Ratwani
5  National Center for Human Factors in Healthcare, MedStar Health, Washington, District of Columbia, United States
6  Georgetown University School of Medicine, Washington, District of Columbia, United States
› Author Affiliations
Further Information

Publication History

27 November 2017

26 March 2018

Publication Date:
16 May 2018 (online)

  

Abstract

Objective The purpose of this study was to further explore the effect of EHRs on emergency department (ED) attending and resident physicians' perceived workload, satisfaction, and productivity through the completion of six EHR patient scenarios combined with workload, productivity, and satisfaction surveys.

Methods To examine EHR usability, we used a live observational design combined with post observation surveys conducted over 3 days, observing emergency physicians' interactions with the EHR during a 1-hour period. Physicians were asked to complete six patient scenarios in the EHR, and then participants filled two surveys to assess the perceived workload and satisfaction with the EHR interface.

Results Fourteen physicians participated, equally distributed by gender (50% females) and experience (43% residents, 57% attendings). Frustration levels associated to the EHR were significantly higher for attending physicians compared with residents. Among the factors causing high EHR frustrations are: (1) remembering menu and button names and commands use; (2) performing tasks that are not straightforward; (3) system speed; and (4) system reliability. In comparisons between attending and resident physicians, time to complete half of the cases as well as the overall reaction to the EHR were statistically different.

Conclusion ED physicians already have the highest levels of burnout and fourth lowest level of satisfaction among physicians and, hence, particular attention is needed to study the impact of EHR on ED physicians. This study investigated key EHR usability barriers in the ED particularly, the assess frustration levels among physicians based on experience, and identifying factors impacting those levels of frustrations. In our findings, we highlight the most favorable and most frustrating EHR functionalities between both groups of physicians.

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects, and was reviewed and approved by the University of North Carolina at Chapel Hill (UNC) Institutional Review Board.