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Perceived electronic health record usability as a predictor of task load and burnout among US physicians: A mediation analysis. Journal of medical Internet research Melnick, E. R., Harry, E., Sinsky, C. A., Dyrbye, L. N., Wang, H., Trockel, M. T., West, C. P., Shanafelt, T. 2020

Abstract

BACKGROUND: EHR usability and physician task load both contribute to physician professional burnout. The association between perceived EHR usability and workload has not previously been studied at a national level. Better understanding these interactions could give further information as to the drivers of extraneous task load.OBJECTIVE: To determine the relationship between physician perceived EHR usability and workload by specialty, and evaluate for associations with professional burnout.METHODS: A secondary analysis of a cross-sectional survey of US physicians from all specialties that was conducted from October 2017 to March 2018. Among the 1,250 physicians invited to respond to the sub-survey analyzed here, 848 (67.8%) completed it. EHR usability was assessed with the System Usability Scale (SUS; range 0-100). Provider task load (PTL) was assessed using the mental demand, physical demand, temporal demand, and effort required subscales of the NASA-Task Load Index (TLX; range 0-400). Burnout was measured using the Maslach Burnout Inventory.RESULTS: The mean scores were SUS 46.1 (SD 46.1) and PTL 262.5 (SD 71.7). On multivariable analysis adjusting for age, gender, relationship status, medical specialty, practice setting, hours worked per week, and number of nights on call per week, physician-rated EHR usability was associated with PTL with each 1 point more favorable SUS score associated with a 0.57 point lower PTL score (p < .001). On mediation analysis, higher SUS was associated with lower PTL, which was associated with lower odds of burnout.CONCLUSIONS: A strong association was observed between EHR usability and workload among US physicians with more favorable usability associated with less workload. Both outcomes were associated with the odds of burnout with task load acting as a mediator between EHR usability and burnout. Improving EHR usability while decreasing task load has the potential to allow practicing physicians more working memory for medical decision-making and patient communication.CLINICALTRIAL: Not applicable.

View details for DOI 10.2196/23382

View details for PubMedID 33289493