Using Objective Clinical Metrics to Understand the Relationship Between the Electronic Health Record and Physician Wellness: An Observational Study

Matthew J Mosquera, MD

Brigham and Women’s Hospital
Using Objective Clinical Metrics to Understand the Relationship Between the Electronic Health Record and Physician Wellness: An Observational Study

Scientific Abstract

Background. Electronic health records (EHRs) are a significant contributor to physicians’ low satisfaction, reduced engagement, and increased burnout. Impairments in physician wellness have damaging effects on provider mental health and the US healthcare system. Yet the majority of evidence around EHR and physician harms is based on self-reported screen time- which may both over and underreport actual exposure. The purpose of this study is to examine how objective EHR use correlates with physician wellness, determine which EHR usage metrics provide greatest utility in the context of physician wellness, and develop preliminary recommendations for wellness-based EHR interventions.

Methods. Prior to onset of COVID-19, psychiatry residents and attendings working in an outpatient clinic at an academic medical center completed scales on wellness, engagement, burnout, and quality of life as well as consented access to EHR usage logs. Survey responses and objective EHR data were analyzed with descriptive statistics.

Results. Responses were obtained from 20 psychiatry residents (74% participation) and 16 clinical faculty members (67% participation) for an overall response rate of 71%. Moderate correlations for multiple wellness domains emerged in analysis for all participants, especially around time spent per note and patient visits closed same day.

Conclusion. EHR usage logs represent a valuable objective tool in the evaluation and enhancement of physician wellness. Selection of metrics should be driven by target population and ability to use metrics in future interventions. Results from our pilot study suggest that metrics for note writing efficiency and closing patient visits same day are associated with physician wellness. These metrics will be important to study in ongoing efforts involving wellness based EHR-interventions.

Live Zoom Session – April 21st

research Areas

Authors

Matthew J Mosquera, MD MS, Heather Burrell Ward, MD,Christopher Holland, Robert Boland, MD, Fremonta, Meyer, MD, John Torous, MD

Affiliated Website