A recent article in Journal of the American Medical Association (JAMA Network Open. 2021;4(10):e2128790. doi:10.1001/jamanetworkopen.2021.28790) describes how analyzing a physician’s use of EHR can be an indicator of his/her reduction in professional effort and intention to leave the job.

Everyone knows that even before Covid, physician burnout was rampant, with about 45% of physicians showing at least one side of burnout at any given time. Surveys (including the most recent Medscape survey) show that excessive time spent on inputting data into the EHR is the single biggest factor in causing burnout. In fact, separate surveys done at Mayo Clinic in 2011 and 2015 showed an increase in burnout which coincided with the introduction of EHR.

So why is this important? Physician burnout causes significant suffering in the healthcare workplace, not just for physicians but also for nurses and ancillary personnel. Burnout is also associated with increased medical errors. Burnout is the single biggest factor in physicians decreasing their work hours, leaving their job or leaving medicine altogether.

A 2019 article In the Annals of Internal Medicine showed that replacing a physician costs his organization between $500,000 and $1 million, and costs the American healthcare system over $4.6 billion annually. So it is in the best interests of an organization to know if a physician is burned out or planning to leave so they can intervene.

Few organizations actually bother to survey their clinicians about fatigue or burnout, and not surprisingly physicians underreport burnout either because of privacy concerns or because they are afraid that it will affect their professional status. Additionally, even fewer organizations have any kind of structured wellness and stress reduction program or professional coaching to help their physicians.

So back to the focus of this article on auditing physicians EHR use. It may be either good or bad depending upon the way the organization uses the data. In a worst-case scenario, predicting whether physician is burned out or planning to leave the job could be used against him by decreasing his work hours and income. In a best case scenario this data could be used to improve EHR usability and/or encourage team documentation to take some of the burden off the physician. I have to hope it is the latter