@Article{chd.12745,
AUTHOR = {Darcy N. Marckini, Bennett P. Samuel, Jessica L. Parker, Stephen C. Cook},
TITLE = {Electronic health record associated stress: A survey study of adult congenital heart disease specialists},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {3},
PAGES = {356--361},
URL = {http://www.techscience.com/schd/v14n3/38790},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> Physician burnout has many undesirable consequences, including nega‐
tive impact on patient care delivery and physician career satisfaction. Electronic 
health records (EHRs) may exacerbate burnout by increasing physician workload.<br/>
<b>Objective:</b> To determine burnout in adult congenital heart disease (ACHD) specialists 
by assessing stress associated with EHRs.<br/>
<b>Design:</b> Electronic survey study of ACHD providers.<br/>
<b>Setting:</b> Canada and United States.<br/>
<b>Participants:</b> Three hundred eighty‐three ACHD specialists listed on the Adult 
Congenital Heart Association directory between February and April 2017.<br/>
<b>Outcome Measures:</b> Burnout was measured using the Maslach Burnout Inventory 
(MBI) to understand factors contributing to work life and EHR satisfaction. Chi‐
square and Wilcoxon Rank Sum tests were used for statistical analysis.<br/>
<b>Results:</b> Of the 383 invited participants, 110 (28.7%) completed surveys with the 
majority (n = 88, 80.7%) reporting from an academic medical center. Burnout was 
defined as high scores on the emotional exhaustion and/or depersonalization MBI 
subscales. When comparing the 40% (n = 44) that met criteria for burnout with those 
that did not, there was strong disagreement that a reasonable amount of time is 
spent on clerical tasks related to direct (P = .0043) or indirect (P = .0004) patient 
care. There was strong disagreement that EHRs increased efficiency (P = .006) or the 
patient portal improved patient care (P = .0215). Finally, physicians who met criteria 
for burnout had lower personal accomplishment scores (P = .0355).<br/>
<b>Conclusions:</b> Our results suggest time spent on EHRs creates clerical burden exacer‐
bating ACHD physician burnout. The high levels of emotional exhaustion may de‐
crease quality of ACHD care by directing focus away from physician‐patient 
interaction. Health care systems must develop best practice for EHR design and im‐
plementation to optimize patient advocacy and care, and decrease physician 
burnout.},
DOI = {10.1111/chd.12745}
}