A retrospective look at the predictions and recommendations from the 2009 AMIA policy meeting: did we see EHR-related clinician burnout coming?

Abstract

Clinicians often attribute much of their burnout experience to use of the electronic health record, the adoption of which was greatly accelerated by the Health Information Technology for Economic and Clinical Health Act of 2009. That same year, AMIA’s Policy Meeting focused on possible unintended consequences associated with rapid implementation of electronic health records, generating 17 potential consequences and 15 recommendations to address them. At the 2020 annual meeting of the American College of Medical Informatics (ACMI), ACMI fellows participated in a modified Delphi process to assess the accuracy of the 2009 predictions and the response to the recommendations. Among the findings, the fellows concluded that the degree of clinician burnout and its contributing factors, such as increased documentation requirements, were significantly underestimated. Conversely, problems related to identify theft and fraud were overestimated. Only 3 of the 15 recommendations were adjudged more than half-addressed.

Identifying and adapting interventions to reduce documentation burden and improve nurses’ efficiency in using electronic health record systems (The IDEA Study): protocol for a mixed methods study

“…7 Clinical Informatics, Sinai Health, Toronto, ON, Canada. 8 Quality and Patient Experience, Sinai Health, Toronto, ON, Canada. 9 Professional Practice, Nursing and Health Disciplines, Sinai Health, Toronto, ON, Canada.…”

“…While EHR systems serve as the backbone of documentation for all clinical activities [3], studies have shown that nurses spend a greater amount of time documenting their assessments, care, and outcomes in the EHR now than in the past [4,5]. While previous initiatives have focused on expanding the design and functionalities of EHRs for research purposes to support clinical decision-making and assist with patient risk assessments [6][7][8][9], the growing burden caused by documentation requirements has overshadowed these efforts and led to inefficiencies in the EHR, taking time away from patient care activities and reducing joy in the profession [7,[9][10][11][12][13][14].…”

Burnout in clinicians

“…Predictions that addressed components of burnout, such as increased documentation, increased cognitive load, data overload and physicians taking early retirement, were all found to be worse than was anticipated 11 years earlier. 33 However, when these informatics leaders were asked to quantify how much EHRs were contributing to the current burnout crisis, most of the respondents believed that EHRs contributed to half or less of the problem.…”

A Mobile, Electronic Health Record-Connected Application for Managing Team Workflows in Inpatient Care

“…The result is a clunky and often frustrating experience for clinicians, associated with increasing time in the electronic chart, confusion, preventable errors, and clinician burnout. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 Clinicians must cope with EHRs that are difficult to navigate and contain large amounts of duplicated, scattered, conflicting, and erroneous information. 15 Further, many EHRs are poorly matched to clinicians' operational models for care delivery.…”