Table 1.
Variables that form EHR-related indicators of physician well-being in our reviewed quantitative studies
| Measure Group | Variable | Definition |
|---|---|---|
| Direct measures of burnout | Reporting burnout | The endorsement of symptoms such as emotional exhaustion, depersonalization, and low personal accomplishment |
| Work-related burnout | One of the domains of the Copenhagen Burnout Inventory that focuses on burnout in the occupational setting | |
| Emotional exhaustion scores | A state in which an individual is fatigued from chronic stress | |
| Depersonalization scores | A state in which an individual feels loses a feeling of self and experiences helplessness | |
| Personal accomplishment scores | A state in which an individual participates in meaningful work | |
| Efficiency and resources | Perceived physician productivity from EHR | Overall level of productivity of EHR workflows felt by the physician |
| Perceived ease of use of EHR | A measure of EHR usability | |
| Number of login events per day | Total amount of times an individual logs into the EHR with a username or password or with badge scanning | |
| SUS composite scores | A validated scale that measures usability of IT systems | |
| Amount of time to document | A measure of documentation burden | |
| QUIS scores | A validated measure of usability of IT systems | |
| User experience rating of EHR | An informal measure of IT systems that broadly covers usability and EHR satisfaction | |
| Time spent in EHR on days without appointments | One measure of EHR use patterns | |
| Minutes spent in EHR on orders per wRVU | Time spent on writing referrals and prescriptions in the EHR | |
| Minutes spent on clinical review in EHR per wRVU | Time spent reading a patient’s chart in the EHR | |
| Minutes spent on in-basket in EHR per wRVU | Time spent looking at, answering, and composing in-basket messages in the EHR | |
| Minutes spent active in EHR on scheduled days after-hours per wRVU | Time spent on any EHR activity outside of normal work hours | |
| Minutes spent on EHR on unscheduled days per wRVU | Time spent on any EHR activity during days where the individual does not have patients scheduled | |
| Amount of inbox notifications | A measure of in-basket burden | |
| Workload and job demands | NASA-TLX scores | A measure of cognitive workload induced from IT usage |
| Effort level required | A measure of how much physical and mental work was needed to use the EHR | |
| Frustration level | A measure of EHR satisfaction that includes level of alignment of personal workflows with EHR workflows as well as overall usability | |
| Mental demand level | A measure that focuses on how much decision making, memory, and information processing was needed | |
| Cognitive load | An informal measure of how much the individual has to rely on memory to complete tasks | |
| EHR satisfaction | Focused satisfaction measure surrounding EHR systems’ ease of use, efficiency, and ability to support workflows | |
| Satisfaction with level of computerization | Satisfaction with the digitization of healthcare processes | |
| Perceived cumbersomeness level | Extent an individual feels the EHR is slow or unusable | |
| Work-life integration | Reporting work-life balance issues | The endorsement that EHR use at home has impacted satisfaction with one’s work-life balance |
| Organizational culture and values | Staff satisfaction/job satisfaction | Broad measure encompassing an individual’s perception at their ability to do a job per their expectations |
EHR: electronic health record; IT: information technology; NASA-TLX: NASA Task Load Index; QUIS: Questionnaire for User Interface Satisfaction; SUS: System Usability Score; wRVU: work relative value unit.