Table 2.

Technostress in EHR-integrated PGHD systems

Causes of Technostress	Conditions
Techno-complexity	EHR-integrated PGHD systems would add new elements and functions. For some physicians, these new functions add complexities to their jobs. More time and efforts are needed in understanding and practicing new skills. Owing to the unsolved standardization issues, various jargon and complicated operation steps make physicians more intimidated and stressed.
Techno-uncertainty	Physicians are not trained as engineers; they are not in favor of continuing technology upgrades and short life cycles of human-computer interaction systems. Taking care of patients is already overwhelming, and being pushed to update knowledge and relearn technical-related skills rapidly makes them unsettled.
Techno-overload	EHR-integrated PGHD systems incorporate more data than traditional EHRs. Physicians have to work harder and even faster because the time has not been extended.
Techno-insecurity	Owing to the different personal characteristics, some physicians who are experiencing technophobia38 may dislike or fear technologies such as the PGHD system. Compared with young physicians or those who can better understand and handle new technologies, these physicians may lag behind and even lose their jobs.
Techno-invasion	With the implementation of EHR-integrated PGHD systems, patients may set higher expectations of their providers. Physicians are supposed to be reached whenever patients want to connect with them and respond to their PGHD-related queries or concerns. Sometimes, patients may even ask technical questions far beyond physicians' responsibilities. This makes physicians expand their regular roles and extend their work hours.

EHR: electronic health record; PGHD: patient-generated health data.