PC2066: Physician Well-being, Empathy, and the EHR: Reducing the Potential Impact of EHR Burden

Background: In the age of technology, the electronic health record (EHR) has emerged as the way of the future. Most medical facilities in the US have implemented some variation of an EHR. However, as the EHR becomes standard practice, it has also been increasingly implicated in a growing physician workload and a rise in burnout rates. In today’s healthcare system, burnout proves to be both a costly and broadly concerning issue. Recent estimates put the total attributable cost of burnout at $4.6 billion annually. Moreover, mounting evidence supports burnout's association with provider depersonalization and reduced empathic capacity, factors that greatly impact care delivery and patient satisfaction. This potential connection between the EHR, burnout symptomatology, and variations in provider empathy is a concerning, but as of yet, relatively unstudied field.

Methods: Our project aims to address this gap by directly quantifying and addressing the impact of the EHR on both physician burnout and empathic capacity. A survey was administered to practicing physicians in outpatient pediatric specialty departments. The survey contained a self-reported burnout score, a rating of EHR burnout contribution, and a validated Jefferson empathy assessment. EHR utilization data (Epic Signal) was collected for each participant in the program prior to and after a specialized educational intervention program aimed at improving those metrics. Using the Mann-Whitney U and Wilcoxon Signed-Rank tests, differences in these metrics were stratified and analyzed according to burnout level, perception of EHR contribution to burnout, and Jefferson empathy scores.

Results: In total, 22 physicians were surveyed. A significant difference in Time Outside Scheduled Hours (TOSH) between those with low vs high empathy (as denoted by Jefferson score) was detected (p = 0.0221). Additionally, those with higher Jefferson scores tended to report a perceived EHR contribution to burnout, although differences in burnout levels between Jefferson Score groupings were not significant. No statistically significant differences in EHR utilization by burnout (self-report or perception of EHR contribution) were detected. EHR metrics were also stratified by gender, but no significant differences were noted. Our efforts to improve these metrics are ongoing and the results for one example division is found on Table 1.

Conclusion: Despite perceptions around the impact of the EHR on physician wellbeing, we were unable to detect differences in EHR metrics among those reporting burnout symptoms. Nonetheless, our program has demonstrated improvement in multiple EHR metrics for those attending our program. Additionally, the significant difference in the time spent charting outside of scheduled hours found between the Jefferson score groups reveals a potential area of concern for providers with high empathic capacity. Investigating and constructing interventions to reduce off-schedule work demands could be of high value to reduce potential burnout in this important group.