TY  - JOUR
AU  - Kruse, Clemens Scott
AU  - Mileski, Michael
AU  - Dray, Gevin
AU  - Johnson, Zakia
AU  - Shaw, Cameron
AU  - Shirodkar, Harsha
PY  - 2022
DA  - 2022/3/31
TI  - Physician Burnout and the Electronic Health Record Leading Up to and During the First Year of COVID-19: Systematic Review
JO  - J Med Internet Res
SP  - e36200
VL  - 24
IS  - 3
KW  - electronic health record
KW  - physician burnout
KW  - quality improvement
KW  - psychiatry
KW  - medical informatics
KW  - COVID-19
KW  - pandemic
KW  - health informatic
KW  - health care
KW  - health care professional
KW  - health care infrastructure
KW  - health care system
KW  - mental health
KW  - cognitive fatigue
AB  - Background: Physician burnout was first documented in 1974, and the electronic health record (EHR) has been known to contribute to the symptoms of physician burnout. Authors pondered the extent of this effect, recognizing the increased use of telemedicine during the first year of COVID-19. Objective: The aim of this review was to objectively analyze the literature over the last 5 years for empirical evidence of burnout incident to the EHR and to identify barriers to, facilitators to, and associated patient satisfaction with using the EHR to improve symptoms of burnout. Methods: No human participants were involved in this review; however, 100% of participants in studies analyzed were adult physicians. We queried 4 research databases and 1 targeted journal for studies commensurate with the objective statement from January 1, 2016 through January 31, 2021 (n=25). Results: The hours spent in documentation and workflow are responsible for the sense of loss of autonomy, lack of work-life balance, lack of control of one’s schedule, cognitive fatigue, a general loss of autonomy, and poor relationships with colleagues. Researchers have identified training, local customization of templates and workflow, and the use of scribes as strategies to alleviate the administrative burden of the EHR and decrease symptoms of burnout. Conclusions: The solutions provided in the literature only addressed 2 of the 3 factors (workflow and documentation time) but not the third factor (usability). Practitioners and administrators should focus on the former 2 factors because they are within their sphere of control. EHR vendors should focus on empirical evidence to identify and improve the usability features with the greatest impact. Researchers should design experiments to explore solutions that address all 3 factors of the EHR that contribute to burnout. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42020201820; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=201820 International Registered Report Identifier (IRRID): RR2-10.2196/15490 
SN  - 1438-8871
UR  - https://www.jmir.org/2022/3/e36200
UR  - https://doi.org/10.2196/36200
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35120019
DO  - 10.2196/36200
ID  - info:doi/10.2196/36200
ER  -