Understanding Physician Work and Well-being Through Social Network Modeling Using Electronic Health Record Data: a...

Area of Science:

• Medical informatics
• Organizational psychology
• Physician well-being research

Background:

• Understanding the association between clinical work environment factors and physician well-being is crucial for enhancing physicians' work experience.
• Previous research has not fully quantified the impact of work composition and team dynamics on physician well-being.

Purpose of the Study:

• To model and quantify the drivers of work composition, team structure, and dynamics associated with physician well-being.
• To identify specific features of physician communication and team interaction that predict well-being outcomes.

Main Methods:

• A cohort study utilizing social network modeling of inbasket messaging data from physicians at an academic health center (2018-2019).
• Electronic Health Record (EHR) data from 188 physicians and their care teams, supplemented by survey data from 163 physicians.
• Logistic regression models assessed out-of-sample using Area Under the Receiver Operating Characteristic Curve (AUC) to predict well-being indicators.

Main Results:

• Models predicting emotional exhaustion, vigor, and professional fulfillment achieved mean AUCs of 0.665, 0.700, and 0.669, respectively.
• Factors associated with decreased well-being included physician centrality in the support team and a high share of scheduling-related messages.
• Factors associated with increased well-being included a higher number of medical assistants, nurse-led message composition, and a higher share of ambiguous diagnosis messages.

Conclusions:

• Integrating EHR data with social network modeling reveals novel characteristics of care team structure and dynamics linked to physician well-being.
• This quantitative methodology offers a data-driven approach to assess and optimize organizational changes for improved physician well-being.
• Findings suggest that refining team dynamics and work composition can positively impact physician well-being and reduce burnout.