Table 3.

Focus group themes

Things that work (successes)	Things that don’t work (stress predictors)	Personal Consequences (outcomes)	How to make it better (organizational fixes)	How to cope with HICT (personal/resilience)
• Patient trends, medical images, and pictures • Messaging (colleagues, patient status, and patient connections) • References, research • Access to all info from anywhere • Allergy alerts; drug interactions • Filters • Legibility • Training/mentoring • Quality of care (ambivalent)	• Click boxes, too many clicks • Short visits, no time to reflect • Doctor–patient interactions • EMR built for billing rather than patient care (thought process lost) • Note bloat (cut and paste) • EMR at home, home not restful, hard to disconnect • IT staff not knowledgeable of clinical issues • Lose lunch, staying late • Too many screening questions • Interoperability (between hospitals) • Hard to find things in chart, fear of missing something • No clear spot for required activities (eg foot exams) • Computer slowdowns • Scanned info lost • No printers in rooms • Stress—“when can I do my notes”? • Population management compromises care of individual patient • Productivity down due to EHR • Need for workarounds/speed • Problem list maintenance • Lack of standardized data curation • Redundancy	• Pain: wrist, neck, back, eye, shoulders, and headaches • Posture • Sleep troubles • Anxiety (regulations, missing things, when to write notes) • Providers dropping out of primary care • Primary care less attractive to students	• Go talk with someone, less pinging • Highlighting key findings • Artificial intelligence • Auto-billing • Badge or fingerprint login (tap and go) • Touchscreen functionality • Care team work to top of license, staff support with In-basket, MAs write orders (watch out for consequences for support staff) • Recurring IT training, including “elbow to elbow” • “Desktop” time slots to catch up on EMR • Decrease # of clicks • Chat room with specialists • Scribes/documentation support (help with data input) • Customizable EMRs • Increase contact time with patients (eg printers in rooms)	• Swimming, spinning, exercise—self care • Set limits, be intentional about work, protect home time, sharpen work/life boundaries • Have routines, walk at lunch • More concise notes/empowerment around note writing • When I’m there I’m there, when I’m not, I’m out • Don’t respond quickly • Think positively • Remember what you cannot control • Take the training and retraining • Customizing your EHR • Talk with residents and colleagues to learn the “tricks” of technology • Reduce clinical hours or work part-time