Source/Disclosures
Disclosures: One study author reports grants from Biomarck Pharmaceuticals outside the submitted work. The other authors report no relevant financial disclosures.
June 16, 2020
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EHR-related fatigue may lead to inefficient use among physicians

Source/Disclosures
Disclosures: One study author reports grants from Biomarck Pharmaceuticals outside the submitted work. The other authors report no relevant financial disclosures.
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Continuous electronic health record use was associated with fatigue among physicians, which may lead to inefficient and suboptimal EHR use, according to results of a study published in JAMA Network Open.

“Our goal was to identify and evaluate the effect of EHR use on physician’s fatigue levels ,” Saif Khairat, PhD, MPH, of Carolina Health Informatics Program at The University of North Carolina at Chapel Hill, told Healio Psychiatry. “Previously, studies investigated that relationship using mostly qualitative methods, such as interviews and satisfaction. This study utilized novel eye-tracking methods to quantify, for the first time, the fatigue levels of physicians while using the EHR system.”

tired doctor slumped at computer
Source: Adobe Stock

In the current cross-sectional, simulation-based study, Khairat and colleagues aimed to evaluate the association between fatigue and EHR use through pupillometry — the measurement of pupil dilation, which has been used to assess engagement with advanced interfaces and website design. Further, they measured efficiency using mouse clicks, time and number of EHR screens. They collected data of 25 intensive care unit physicians and physician trainees at a southeastern U.S. academic medical center. Participants completed four simulated patient cases in the EHR involving task execution and information retrieval while wearing eye-tracking glasses. Physician fatigue and EHR efficiency were the primary outcomes.

Saif Khairat

Participants recorded 14 hours and 27 minutes of EHR activity. Results showed that all exhibited psychological fatigue one or more times during the exercise, and 80% exhibited psychological fatigue within the first 22 minutes of EHR use. Those who exhibited fatigue in one patient case were less efficient in the following patient case, according to task completion times, higher numbers of mouse clicks and more EHR screen visits.

“The well-being of health care professionals is directly related to patient safety, especially during the COVID-19 pandemic, where fatigue levels among frontline health care professionals are rapidly growing,” Khairat told Healio Psychiatry. “Since the EHR is a contributor to physician fatigue, there needs to be proactive initiative to minimize EHR burdens while maintaining high performance and quality of care.”