Physicians’ Well-Being Linked To In-Basket Messages Generated By Algorithms In Electronic Health Records

Tai-Seale, Ming; Dillon, Ellis C; Yan, Yang; Nordgren, Robert; Steinberg, Ruth; Nauenberg, Teresa; Lee, Tim C.; Meehan, Amy; Li, Jinnan; Chan, Albert; Frosch, Dominick L.

doi:10.1377/hlthaff.2018.05509

Cited by 160 publications

(172 citation statements)

References 20 publications

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“…Interviews were conducted by three researchers (ED, AM, and MTS) between June to October 2017, and the average duration was 1 hour. Interviews included a review of factors associated with burnout at the organization based on findings from the survey 27 along with drivers of burnout described in the literature. 21,27 Participants were asked to identify the most salient factors contributing to burnout using a card sorting exercise, 28 and were then asked questions about these identified factors (see interview guide in online Appendix 1).…”

Section: Methodsmentioning

confidence: 99%

“…Initial deductive codes were identified from prior research. 21,27 The coders began with descriptive and open coding using both pre-identified and emergent codes, including proposed strategies for reducing burnout. The second cycle of coding categorized codes into themes using a pattern coding approach, 27,30 and matched factors to solutions suggested to improve well-being.…”

Section: Methodsmentioning

confidence: 99%

“…[24][25][26] Other studies analyze survey data, which lack nuanced information about the experience of burnout and do not typically explore strategies to improve well-being. A recent survey of 934 physicians in our organization identified a number of risk factors for burnout, 27 and this research is a qualitative companion study aimed at understanding perspectives of frontline physicians and health system leaders on contributors to burnout and potential solutions.…”

Section: Introductionmentioning

confidence: 99%

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Frontline Perspectives on Physician Burnout and Strategies to Improve Well-Being: Interviews with Physicians and Health System Leaders

et al. 2019

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BACKGROUND: Nationally over 50% of physicians report symptoms of burnout. OBJECTIVE: To understand the perspectives of health system leaders and frontline physicians on contributors to physician burnout and strategies to improve wellbeing. DESIGN: We conducted in-depth interviews with health system leaders and frontline physicians at a large, predominantly fee-for-service, multispecialty group practice with approximately 1300 physicians. PARTICIPANTS: The 17 participants included 15 physicians, (12 Internal Medicine and Family Medicine physicians and 3 from other specialties), 11 individuals in leadership roles, and 11 women. APPROACH: Interviews included a review of factors associated with burnout at the organization, asking participants which factors they believed contributed to burnout, questions about experiences of burnout, and what specific changes would improve well-being. KEY RESULTS: All 17 participants agreed that organizational factors were key contributors to burnout, while only 9 mentioned the salience of individual factors: "It does not matter how resilient or positive you are, the work environment, especially in primary care will eventually be a problem." An increasing workload associated with the electronic health record (EHR) and a culture focused on productivity were cited as contributing to burnout, especially among physicians in Internal Medicine and Family Medicine (primary care) departments. Physicians in primary care, women, and leaders described multiple barriers to well-being. Participants described responding to increased workloads by reducing clinical work hours. Participants suggested reducing and compensating EHR work, expanding care teams/support staff, reducing use of metrics, providing more support to leaders, changing the business model, and increasing positivity and collegiality, as essential to improving well-being. CONCLUSION: Interviews reveal a variety of interacting factors contributing to physician burnout. Reducing clinical work hours has become a coping strategy. Changes recommended to improve physician well-being include increasing support staff, reducing EHR workload, changing revenue generation and compensation approaches, and shifting organizational culture to place more value on physician wellness.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Frontline Perspectives on Physician Burnout and Strategies to Improve Well-Being: Interviews with Physicians and Health System Leaders

et al. 2019

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“…Currently, scant published information exists to help operational leaders and practicing physicians understand the stressors associated with the electronic inbox and the array of possible strategies for management. [4][5][6][8][9][10] We studied physician perspectives on this topic in one of the largest medical groups in the nation. This study's aims were to describe how electronic inbox management has affected current medical practice, to identify resulting stressors, and to characterize a wide range of management strategies by individual physicians and practice groups.…”

Section: Introductionmentioning

confidence: 99%

Primary Care Physicians’ Experiences With and Strategies for Managing Electronic Messages

et al. 2019

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IMPORTANCE The increasing use of electronic communications has enhanced access to physicians for patients and clinical staff. Primary care physicians (PCPs) have anecdotally identified electronic inbox management as a new source of work-related stress. OBJECTIVES To describe PCPs' experiences managing their electronic inboxes and to characterize the array of management strategies developed by individual physicians and practice groups. DESIGN, SETTING, AND PARTICIPANTS This qualitative study was conducted in 8 medical centers of a large group practice with more than 4 million patients in diverse settings and a mature electronic health record. The group encourages patients to use portal secure messaging to enhance access to their physicians and the care experience. Semistructured interviews were conducted with 24 internists and family medicine physicians identified via snowball sampling. Interviews were

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“…5,6 More than having too much data, information overload occurs when more information is presented than can be readily processed, thereby exceeding coping strategies, causing a loss of situational awareness, increasing the risk of missing important information, increasing times finding and organizing information, and potentially leading to physician burnout. [7][8][9][10][11] More information does not necessarily mean more effective decision making or care. 8,12…”

Section: The 21st Century Cures Act and Information Blockingmentioning

confidence: 99%

A Viewpoint on the Information Sharing Paradox

2020

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Physicians’ Well-Being Linked To In-Basket Messages Generated By Algorithms In Electronic Health Records

Cited by 160 publications

References 20 publications

Frontline Perspectives on Physician Burnout and Strategies to Improve Well-Being: Interviews with Physicians and Health System Leaders

Frontline Perspectives on Physician Burnout and Strategies to Improve Well-Being: Interviews with Physicians and Health System Leaders

Primary Care Physicians’ Experiences With and Strategies for Managing Electronic Messages

A Viewpoint on the Information Sharing Paradox

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