Relationship Between Clerical Burden and Characteristics of the Electronic Environment With Physician Burnout and Professional Satisfaction.
To evaluate associations between the electronic environment, clerical burden, and burnout in US physicians.



Physicians across all specialties in the United States were surveyed between August and October 2014. Physicians provided information regarding use of electronic health records (EHRs), computerized physician order entry (CPOE), and electronic patient portals. Burnout was measured using validated metrics.



Of 6375 responding physicians in active practice, 5389 (84.5%) reported that they used EHRs. Of 5892 physicians who indicated that CPOE was relevant to their specialty, 4858 (82.5%) reported using CPOE. Physicians who used EHRs and CPOE had lower satisfaction with the amount of time spent on clerical tasks and higher rates of burnout on univariate analysis. On multivariable analysis, physicians who used EHRs (odds ratio [OR]=0.67; 95% CI, 0.57-0.79; P<.001) or CPOE (OR=0.72; 95% CI, 0.62-0.84; P<.001) were less likely to be satisfied with the amount of time spent on clerical tasks after adjusting for age, sex, specialty, practice setting, and hours worked per week. Use of CPOE was also associated with a higher risk of burnout after adjusting for these same factors (OR=1.29; 95% CI, 1.12-1.48; P<.001). Use of EHRs was not associated with burnout in adjusted models controlling for CPOE and other factors.



In this large national study, physicians' satisfaction with their EHRs and CPOE was generally low. Physicians who used EHRs and CPOE were less satisfied with the amount of time spent on clerical tasks and were at higher risk for professional burnout.
Division of Hematology, Mayo Clinic, Rochester, MN. Electronic address: shanafelt.tait@mayo.edu.
Tait D
TD
Shanafelt
Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN.
Lotte N
LN
Dyrbye
American Medical Association, Chicago, IL.
Christine
C
Sinsky
American Medical Association, Chicago, IL.
Omar
O
Hasan
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
Daniel
D
Satele
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
Jeff
J
Sloan
Division of General Internal Medicine, Mayo Clinic, Rochester, MN.
Colin P
CP
West
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D002055:Burnout, Professional / Q000453:epidemiology / Q000523:psychology*; D004282:Documentation / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D057286:Electronic Health Records / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D005568:Forms and Records Control / Q000379:methods / Q000592:standards; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D050316:Medical Order Entry Systems / Q000592:standards* / Q000706:statistics & numerical data; D008511:Medicine / Q000145:classification / Q000706:statistics & numerical data; D008875:Middle Aged; D000072638:Patient Portals / Q000592:standards / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology