Mining EHR data to understand documentation burnout

The Office of the National Coordinator for Health Information found that hospitals’ access and analysis of documentation data in electronic health records has increased over the past five years, but gaps in access and use remain for some hospitals.

Data from EHRs can track the time clinicians spend documenting and carrying out certain tasks. To measure physician burden on a national scale, ONC analyzed four waves of a nationally representative survey of U.S. non-federal acute care hospitals.

Published in January, in the special health IT issue of the American Journal of Managed Care, Trends in Electronic Health Record Capabilities for Tracking Documentation Time examined trends in access and use of data from EHR developers that quantify the amount of time clinicians spend documenting clinical care between 2017 and 2021.

Using audit log data to assess EHR burden can improve clinical workflows, monitor performance and efficiency and reduce documentation burdens, said ONC Economist Chelsea Richwine in a recent blog post about leveraging EHR audit data to inform and improve clinical workflows.

“Improving data accessibility and aiding interpretation via tools and dashboards can increase the utility of these data by making them more actionable for organizational decision-makers,” she said.

“This has important implications for the ability of organizations to reduce burden, improve job satisfaction for clinicians and mitigate burnout and staff turnover – issues that have been exacerbated by the pandemic.”

Richwine and co-author Dr. Vaishali Patel also found that a higher proportion of hospitals with access to EHR documentation time measures used them for more purposes over time.

But access to the data is an issue for some hospitals.

“Despite hospitals’ increased access to measures that track EHR time, lower-resourced hospitals, nonteaching hospitals and hospitals with non–market-leading EHR developers were less likely to report having access than their counterparts,” they said in the study.

The ONC analysts recommended that future research efforts investigate whether the use of EHR audit log data and similar measures translates into reduced provider burdens.

While the burnout rate among doctors spiked to an all-time high with the onset of the COVID-19 pandemic –  with one in five physicians planning to leave the profession – strategies such as timely and well-communicated EHR fixes and those that address after-hours charting have helped to level off provider burnout rates.

In a November 2022 report, Provider Burnout and the EHR Experience, researchers with the KLAS Arch Collaborative found that since 2021, high levels of trust in organizational leadership around the EHR correlated with a lower percentage of providers reporting burnout.

They also found that reduced after-hours workloads can decrease burnout significantly.

“One key to lessening provider burnout is strong provider agreement that their organization delivers well around the EHR – specifically, that the organization has done a great job of implementing, training on and supporting the EHR,” said KLAS researchers in the report.

“Making [audit] data more accessible could significantly improve hospital organizations’ and physician practices’ ability to monitor the amount of time their clinicians spend in the EHR,” said Richwine in the ONC blog post.

“Moreover, improving data accessibility and aiding interpretation via tools and dashboards can increase the utility of these data by making them more actionable for organizational decision-makers.”

Andrea Fox is senior editor of Healthcare IT News.
Email: [email protected]

Healthcare IT News is a HIMSS Media publication.

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