J Am Med Inform Assoc - Electronic medical records and physician stress in primary care: results from the MEMO Study.

Tópicos

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Resumo

CKGROUND: Little has been written about physician stress that may be associated with electronic medical records (EMR).OBJECTIVE: We assessed relationships between the number of EMR functions, primary care work conditions, and physician satisfaction, stress and burnout.DESIGN AND PARTICIPANTS: 379 primary care physicians and 92 managers at 92 clinics from New York City and the upper Midwest participating in the 2001-5 Minimizing Error, Maximizing Outcome (MEMO) Study. A latent class analysis identified clusters of physicians within clinics with low, medium and high EMR functions.MAIN MEASURES: We assessed physician-reported stress, burnout, satisfaction, and intent to leave the practice, and predictors including time pressure during visits. We used a two-level regression model to estimate the mean response for each physician cluster to each outcome, adjusting for physician age, sex, specialty, work hours and years using the EMR. Effect sizes (ES) of these relationships were considered small (0.14), moderate (0.39), and large (0.61).KEY RESULTS: Compared to the low EMR cluster, physicians in the moderate EMR cluster reported more stress (ES 0.35, p=0.03) and lower satisfaction (ES -0.45, p=0.006). Physicians in the high EMR cluster indicated lower satisfaction than low EMR cluster physicians (ES -0.39, p=0.01). Time pressure was associated with significantly more burnout, dissatisfaction and intent to leave only within the high EMR cluster.CONCLUSIONS: Stress may rise for physicians with a moderate number of EMR functions. Time pressure was associated with poor physician outcomes mainly in the high EMR cluster. Work redesign may address these stressors.

Resumo Limpo

ckground littl written physician stress may associ electron medic record emrobject assess relationship number emr function primari care work condit physician satisfact stress burnoutdesign particip primari care physician manag clinic new york citi upper midwest particip minim error maxim outcom memo studi latent class analysi identifi cluster physician within clinic low medium high emr functionsmain measur assess physicianreport stress burnout satisfact intent leav practic predictor includ time pressur visit use twolevel regress model estim mean respons physician cluster outcom adjust physician age sex specialti work hour year use emr effect size es relationship consid small moder larg key result compar low emr cluster physician moder emr cluster report stress es p lower satisfact es p physician high emr cluster indic lower satisfact low emr cluster physician es p time pressur associ signific burnout dissatisfact intent leav within high emr clusterconclus stress may rise physician moder number emr function time pressur associ poor physician outcom main high emr cluster work redesign may address stressor

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