Physicians' Complex Relationships With Health Information Technology and Burnout: Cross-Sectional Survey Study.

چکیده اصلی

BACKGROUND: Health information technology (HIT), while designed to improve practice efficiency and patient care, can contribute to physician burnout when designed without clinical practice in mind. Administrative and clinical demands now require physicians to spend more time on HIT, a burden that contributes to burnout and affects time with patients. OBJECTIVE: This study had two objectives: (1) to examine how physician perceptions of specific HIT functions may alleviate or contribute to physician burnout within the differing health care landscapes of Ontario and Nova Scotia, with particular attention given to physician perceptions of HIT associated with administrative burdens, interoperability, and system integration, and (2) to explore physician experiences and perceptions of HIT as potential factors affecting physician burnout, with the goal of delivering findings (eg, a model) that could be applied to improve physicians' HIT experience. METHODS: We designed an exploratory mixed methods study that deployed a cross-sectional survey in 2 Canadian provinces: Ontario and Nova Scotia. Centralized clinician management software (Ontario) and medical association networks (Nova Scotia) were used to recruit from an estimated 35,341 (Ontario) and 2809 (Nova Scotia) physicians. The survey was distributed between February and April 2024. Nonphysician clinicians, clinic staff, and non-HIT users were excluded, resulting in 1245 Ontario and 136 Nova Scotia physician HIT-user respondents. For both the Ontario and Nova Scotia samples, descriptive analyses of quantitative survey items were compared, and open-text responses were subjected to qualitative coding for themes. Subgroup differences in HIT-related burnout were analyzed in the larger Ontario sample. RESULTS: Common experiences were apparent despite differences in the samples, provincial health systems, and available HIT. "Managing communications related to patient care" and "inputting data into your EMR" were among the top 3 administrative burdens. While "logging in and out of technology platforms" ranked higher in Nova Scotia as an administrative burden, the related theme of integration and interoperability was prominent in both samples. In the Ontario sample, perceptions of HIT, quality of support, and hours worked per week accounted for over half of the variation in self-reported burnout. CONCLUSIONS: While physicians appreciate the advantages of HIT for patient care, they also experience an overwhelming administrative and documentation burden, as well as disjointedness across data platforms, which contributes to their burnout. Greater ongoing involvement by end users in the design and usability of these technologies, along with improved standardization and interoperability, would reduce these burdens while maintaining the benefits of digital health systems.

ترجمه فارسی چکیده

هدف این مطالعه بررسی این بود که آیا درک پزشکان از توابع خاص فناوری اطلاعات سلامت (HIT) می‌تواند فرسودگی شغلی را کاهش دهد یا تشدید کند و همچنین تجربیات و درک پزشکان از HIT به عنوان عوامل مؤثر بر فرسودگی را بررسی کند. این مطالعه یک مطالعه ترکیبی اکتشافی با استفاده از پیمایش مقطعی در دو استان کانادا، اونتاریو و نوا اسکوشیا انجام شد. نمونه‌ها شامل 1245 پزشک در اونتاریو و 136 پزشک در نوا اسکوشیا بودند. نتایج نشان داد که مدیریت ارتباطات مرتبط با مراقبت بیمار و ورود داده‌ها به سیستم ثبت الکترونیک بیمار (EMR) از بارهای اداری شایع بودند. در نمونه اونتاریو، درک پزشکان از HIT، کیفیت پشتیبانی و ساعات کار در هفته بیش از نیمی از تغییرات در فرسودگی خودگزارش‌شده را توضیح دادند. نتیجه‌گیری این است که اگرچه پزشکان از مزایای HIT برای مراقبت بیمار آگاه هستند، اما بارهای اداری و مستندسازی سنگین و ناهماهنگی در پلتفرم‌های داده باعث فرسودگی آن‌ها می‌شود.

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