Table 3.
Association of EHR variables and burnout
| Reference number |
|||
|---|---|---|---|
| Positive Association | Negative Association | Not Significant | |
| General EHR use factors | |||
| EHR use | 36 a | 4 , 36 b | |
| Remote EHR use | 17 , 37 | ||
| Time spent on EHR | 51 | 31 | |
| EHR at home | 17 , 39 , 43 c | 34 d , 37 , 42 | |
| EHR after work hour | 35 , 47 | 31 | |
| Time spent on EHR on unscheduled days | 47 | ||
| Average # of logons after work hour | 31 | ||
| High % of time spent on EHR after work hour/total time logged on | 31 | ||
| Negative health consequences from EHR use | 40 | ||
| Intervention—EHR training, workflow redesign, and addition of specialty-specific EHR functions | 44 | ||
| Opinions of EHR | |||
| General opinions of EHR | 48 | ||
| Belief that EHR adds frustration | 17 , 37 , 52 | ||
| Disagree that EHR keeps patient safe | 52 | ||
| Disagree that EHR communications are efficient | 52 | ||
| Disagree that EHR improved efficiency | 41 | ||
| Dissatisfaction with EHR | 52 | ||
| Dissatisfaction with patient care related clerical tasks on EHR | 41 | ||
| Dissatisfaction with patient care unrelated clerical tasks on EHR | 41 | ||
| EHR usability | |||
| # of EHR features available | 30 | ||
| High EHR usability | 50 | ||
| EHR user proficiency/efficiency | |||
| EHR proficiency | 34 d 43 c 47 | ||
| EHR efficiency | 42 , 47 | ||
| Greater # of different EHR system used | 35 | ||
| Longer experience with any specific EHR | 35 | ||
| Length of current EHR in place | 35 | ||
| Messaging or communication within EHR | |||
| Time spent on inbox alert messages | 33 | ||
| High # of inbox messages | 45 , 47 | ||
| High # of patient call messages | 49 e f | ||
| High # of result messages | 49 e f | ||
| Insufficient time to deal with inbox alert messages | 33 | ||
| Patient portal use | 4 | ||
| Disagree that patient portal has improved efficiency | 41 | ||
| EHR chart review | |||
| Time spent on chart review | 49 e f | ||
| Use of Chart Search function | 49 e f | ||
| EHR documentation | |||
| Insufficient time for documentation | 17 , 34 d 37 , 39 , 42 , 43 c | ||
| Note length in EHR | 49 e f | ||
| Precharting of visit notes | 49 e f | ||
| High % of note entered using copy and paste | 49 b | ||
| High % of note entered using SmartTools | 49 f | ||
| High # of user SmartPhrases | 49 e f | ||
| Use of transcription or voice recognition for notes | 49 f | ||
| Uses scribes | 17 , 37 , 47 , 49 ef | ||
| EHR order function | |||
| High # of medication orders authorized | 49 e f | ||
| High # of nonmedication orders authorized | 49 e f | ||
| CPOE use | 4 | ||
| % of orders placed from preference list or SmartSet | 49 e f | ||
Statistically significant results on bivariate analysis but not significant on multivariate analysis were considered not significant. Not significant results from bivariate analysis not included in multivariate analysis are included in this table as not significant. For studies reporting each subdomains of burnout as outcome separately, statistically significant outcome in any one domain is considered significant result for the study. P value<.05 is considered significant.
CPOE: computerized provider order entry; EHR: electronic health record.
Multivariate modal with prevalence of burnout on neonatal intensive care unit level as outcome.
Mixed effect modal with neonatal intensive care unit as random effect and individual burnout as outcome.
Multivariate modal with burnout as outcome measured by Maslach Burnout Inventory and multivariate modal with burnout as outcome measured by Mini-Z showed consistent results thus were not reported separately in this table.
The modal with demographic, practice characteristics, and other variables of the survey all included in the model is used.
Multivariate modal with complete sample without note composition data.
Multivariate modal with subset of clinicians with note composition data.