A new article published this past week in the Journal of the American Medical Informatics Association found that electronic health record-integrated patient-generated health data may create burdens for clinicians, leading to burnout.
In particular, researchers from Northwestern University found that technostress, time pressure and workflow-related issues need to be addressed to accelerate the integration of patient-generated health data into clinical care.
“Clinician burnout is not only a syndrome of emotional exhaustion, but also a type of cynicism about job responsibilities,” wrote Jiancheng Ye, a PhD student at Northwestern University, in the article.
“Burnout is a reaction marked by lacking the sense of accomplishment, feeling emotionally exhausted and experiencing depersonalization,” Ye continued.
WHY IT MATTERS
As the article notes, technology such as wearables, smartphone apps and remote monitoring devices increasingly collect health-related patient information, which they then share in turn with healthcare providers.
The article focuses on two main health data elements: patient-reported outcomes reported directly from patients in the form of questionnaires, and mobile health.
“Coupled with deployed electronic health records, patient portals and secure messaging, these new types of data enable patients to actively engage in the health care process, further improving the connection with their HCPs,” Ye wrote.
However, interactions with EHR-integrated patient-generated health data may also result in clinician burnout.
Ye identifies three main factors: technostress, time pressure and workflow-related issues.
Technostress encompasses a wide range of concerns, including new tool complexities, insecurity around new tools and “techno-overload”: “Physicians have to work harder and even faster because the time has not been extended.”
In addition, the article notes, being pushed to update knowledge and relearn technical skills can unsettle physicians.
As far as time pressure is concerned, Ye notes that physicians are expected to interpret the data before or during the patient visit under strict time constraints. While allotted time remains constant, the expectations of how much providers must accomplish may increase.
Finally, with regard to workflow-related issues, the article flags how data-EHR integration may lead to information overload.
“In some cases, the [patient-generated health data] systems send the patient’s data directly to a physician, likely through their mobile phones or electronic messaging systems. This mechanism, while efficient in urgent situations, may be burdensome to [providers] and can lead to fatigue if not all notifications are relevant,” wrote Ye.
Ye also explains that lack of interoperability can lead to fragmented information sources or render the data unreadable.
The article proposes a number of strategies to address these burnout sources, including giving providers clear role assignments, developing standardized templates and data types for patient information integration, incorporating artificial intelligence into the system and making workflows automatic.
“If physicians find it easy and comfortable to review and interpret [patient-generated health data], then burnouts will decrease,” wrote Ye.
THE LARGER TREND
In a recent study, women and critical care physicians reported highest levels of burnout, pointing to long hours and bureaucratic tasks as the main culprits – although COVID-19 certainly hasn’t helped matters.
ON THE RECORD
“Health systems should regularly evaluate the impact of the EHR-integrated [patient-generated health data] on clinicians, eliminate redundancies, and simplify the workflows,” read the article.