A qualitative study of the dark and bright sides of physicians' electronic health record work outside work hours.

IF 1.7 3区 医学 Q3 HEALTH POLICY & SERVICES
Selasi Attipoe, Daniel M Walker, Sharon B Schweikhart, Jennifer L Hefner
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Abstract

Background: The introduction of electronic health records (EHRs) has contributed considerably to EHR work outside work (WOW) hours for physicians. Prior research has identified the pressures associated with stress resulting from EHR WOW, yet developing a nuanced understanding of how physicians appraise and respond to this stress, and the resulting impacts, remains absent from the literature.

Purpose: Grounded in the technostress model, this study takes a qualitative approach to explore both the pressures and opportunities associated with EHR WOW.

Methods: Thematic analysis of data from semistructured interviews was utilized to examine the pressures and opportunities associated with EHR WOW among primary care pediatricians (n = 15) affiliated with a large Midwestern pediatric health system.

Results: The physicians in this study regularly spent time working in the EHR outside work hours. They felt the EHR contributed to their documentation burden, which ultimately increased their EHR WOW, and reported a sense of burden from ubiquitous EHR availability. Conversely, they appreciated the flexibility the EHR provided in terms of work-life balance. Suggestions for improvement under the direct purview of practice management included enhanced EHR usability, improvements in workflow during work hours to free up time to document, and more training on both EHR documentation strategies and ongoing software upgrades.

Conclusion: Physicians perceive that the EHR exerts certain pressures while affording new opportunities and conveniences. This study provides evidence of both the pressures and opportunities of EHR WOW and their effect on physician well-being.

Practice implications: Specific opportunities are identified for health administrators to enable physicians to better manage EHR WOW.

医生工作时间外电子病历工作的黑暗面和光明面定性研究。
背景:电子健康记录(EHRs)的引入对医生在工作时间以外的电子健康记录工作(WOW)做出了很大的贡献。先前的研究已经确定了与EHR WOW相关的压力,然而,对于医生如何评估和应对这种压力以及由此产生的影响,文献中仍然缺乏细致入微的理解。目的:本研究以技术压力模型为基础,采用定性方法探讨与电子病历WOW相关的压力和机会。方法:对来自半结构化访谈的数据进行主题分析,以检查隶属于中西部大型儿科卫生系统的初级保健儿科医生(n = 15)与EHR WOW相关的压力和机会。结果:本研究的医生在工作时间之外经常在电子病历中工作。他们认为EHR增加了他们的文档负担,最终增加了他们的EHR WOW,并报告了无处不在的EHR可用性带来的负担感。相反,他们欣赏电子病历在工作与生活平衡方面提供的灵活性。在实践管理的直接权限下提出的改进建议包括增强EHR可用性,改进工作时间内的工作流以腾出时间编写文档,以及对EHR文档策略和正在进行的软件升级进行更多培训。结论:医生认为电子病历在提供新的机会和便利的同时也带来了一定的压力。本研究为EHR WOW的压力和机会以及它们对医生幸福感的影响提供了证据。实践意义:确定了卫生管理人员的具体机会,使医生能够更好地管理EHR WOW。
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来源期刊
Health Care Management Review
Health Care Management Review HEALTH POLICY & SERVICES-
CiteScore
4.70
自引率
8.00%
发文量
48
期刊介绍: Health Care Management Review (HCMR) disseminates state-of-the-art knowledge about management, leadership, and administration of health care systems, organizations, and agencies. Multidisciplinary and international in scope, articles present completed research relevant to health care management, leadership, and administration, as well report on rigorous evaluations of health care management innovations, or provide a synthesis of prior research that results in evidence-based health care management practice recommendations. Articles are theory-driven and translate findings into implications and recommendations for health care administrators, researchers, and faculty.
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