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J Am Med Inform Assoc. 2019 Aug 28. pii: ocz126. doi: 10.1093/jamia/ocz126. [Epub ahead of print]

Physicians' gender and their use of electronic health records: findings from a mixed-methods usability study.

Author information

1
Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
2
School of Nursing, University of North Carolina at Chapel Hill, North Carolina, USA.
3
Preventive Medicine Residency Program, Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
4
Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA.
5
Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
6
Sociology Department and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
7
Department of Biomedical Informatics, University at Buffalo, Buffalo, New York, USA.

Abstract

OBJECTIVE:

Physician burnout associated with EHRs is a major concern in health care. A comprehensive assessment of differences among physicians in the areas of EHR performance, efficiency, and satisfaction has not been conducted. The study sought to study relationships among physicians' performance, efficiency, perceived workload, satisfaction, and usability in using the electronic health record (EHR) with comparisons by age, gender, professional role, and years of experience with the EHR.

MATERIALS AND METHODS:

Mixed-methods assessments of the medical intensivists' EHR use and perceptions. Using simulated cases, we employed standardized scales, performance measures, and extensive interviews. NASA Task Load Index (TLX), System Usability Scale (SUS), and Questionnaire on User Interface Satisfaction surveys were deployed.

RESULTS:

The study enrolled 25 intensive care unit (ICU) physicians (11 residents, 9 fellows, 5 attendings); 12 (48%) were men, with a mean age of 33 (range, 28-55) years and a mean of 4 (interquartile range, 2.0-5.5) years of Epic experience. Overall task performance scores were similar for men (90% ± 9.3%) and women (92% ± 4.4%), with no statistically significant differences (P = .374). However, female physicians demonstrated higher efficiency in completion time (difference = 7.1 minutes; P = .207) and mouse clicks (difference = 54; P = .13). Overall, men reported significantly higher perceived EHR workload stress compared with women (difference = 17.5; P < .001). Men reported significantly higher levels of frustration with the EHR compared with women (difference = 33.15; P < .001). Women reported significantly higher satisfaction with the ease of use of the EHR interface than men (difference = 0.66; P =.03). The women's perceived overall usability of the EHR is marginally higher than that of the men (difference = 10.31; P =.06).

CONCLUSIONS:

Among ICU physicians, we measured significant gender-based differences in perceived EHR workload stress, satisfaction, and usability-corresponding to objective patterns in EHR efficiency. Understanding the reasons for these differences may help reduce burnout and guide improvements to physician performance, efficiency, and satisfaction with EHR use.

DESIGN:

Mixed-methods assessments of the medical intensivists' EHR use and perceptions. Using simulated cases, we employed standardized scales, performance measures, and extensive interviews.

KEYWORDS:

EHR; burnout; critical care; efficiency; performance; satisfaction

PMID:
31504578
DOI:
10.1093/jamia/ocz126

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