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Physicians' Well-Being Linked To In-Basket Messages Generated By Algorithms In Electronic Health Records
Ming Tai-Seale1, Ellis C Dillon2, Yan Yang3
1Ming Tai-Seale ( mtaiseale@ucsd.edu ) is a professor in the Department of Family Medicine and Public Health, University of California San Diego; director of outcomes analysis and scholarship at UC San Diego Health; and director of research at UCSD Health Sciences International, in La Jolla.
Insights
High volumes of electronic health record (EHR) in-basket messages contribute to physician burnout. Redesigning EHR workflows and improving work environments are crucial for physician well-being.
Area of Science:
- Medical Informatics
- Physician Well-being
- Healthcare Management
Background:
- Physician workload is a growing concern, particularly regarding electronic health records (EHRs).
- The impact of EHR in-basket messages on physician well-being remains under-examined.
- Physician burnout and intent to reduce clinical hours are significant issues in healthcare.
Purpose of the Study:
- To investigate the relationship between the volume and sources of physician in-basket messages and their well-being.
- To identify factors contributing to physician burnout and intent to reduce clinical work.
- To explore the role of the work environment in physician satisfaction and well-being.
Main Methods:
- Analysis of in-basket message data from physicians in a multispecialty practice.
- Survey assessing physician burnout symptoms, intent to reduce clinical work, and work environment perceptions.
- Statistical analysis to correlate in-basket message volume, sources, and work environment with well-being outcomes.
Main Results:
- EHR system-generated messages comprised nearly half of the average 243 weekly in-basket messages per physician.
- Higher numbers of system-generated messages correlated with increased probability of burnout (40%) and intent to reduce work hours (38%).
- Positive work environments were linked to lower burnout, reduced intent to decrease work hours, and higher life satisfaction. Female physicians reported higher burnout risk.
Conclusions:
- EHR in-basket message overload significantly impacts physician burnout and workforce decisions.
- Improving EHR workflow design and fostering supportive work environments are essential for physician well-being.
- Addressing gender-specific disparities in well-being is also necessary for a healthier physician workforce.
Abstract:
Despite concerns about physicians' workload associated with electronic health records (EHRs), little attention has been paid to the relationship between physicians' well-being and the in-basket messages physicians receive-specifically, their volume and sources. Analyses of EHR work performed by physicians in a multispecialty practice found that in-basket messages generated by the EHR system accounted for almost half (114) of the 243 weekly in-basket messages received per physician, on average-far exceeding the numbers received from their colleagues (53) and patients (30). In a survey, 36 percent of the physicians reported burnout symptoms, and 29 percent intended to reduce their clinical work time in the upcoming year. Receiving more than the average number of system-generated in-basket messages was associated with 40 percent higher probability of burnout and 38 percent higher probability of intending to reduce clinical work time. Physicians' perceptions of a positive work environment were associated with lower odds of burnout and intention to reduce clinical work time and with greater satisfaction with life. Female physicians had a higher risk of burnout and lower satisfaction with life, compared to males. Meaningful redesign of EHR in-basket workflow and a wellness-enhancing work environment are necessary to effectively improve physicians' well-being.