The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians
The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians
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DOI：
10.1016/j.mayocp.2019.09.024
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发表时间：
2020-03-01
影响因子：
8.9
通讯作者：
Shanafelt, Tait
中科院分区：
文献类型：
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作者：
Melnick, Edward R.;Dyrbye, Liselotte N.;Shanafelt, Tait
目的：描述和基准医生感知的电子健康记录（EHR）可用性定义的技术可用性的标准化度量，并评估与医生职业倦怠之间的关联。这项针对所有专业学科的美国医生的横断面调查于2017年10月12日至2018年3月15日进行，使用美国医学协会医师主文件。在30,456名受邀医生中，5197人（17.1%）完成了调查。在初步调查中随机25%（n=1250）的受访者接受了评估EHR可用性的子调查，870（69.6%）完成了调查。EHR可用性使用系统可用性量表（SUS;范围0-100）进行评估。SUS评分标准化为来自其他行业的1300多项先前研究的百分位数排名。结果：平均+/- SD SUS评分为45.9 +/- 21.9。45.9分是在过去的研究中得分最低的9%，并被归类为“不可接受”范围或F级。在多变量分析中调整了年龄、性别、医学专业、实践环境、工作时间和每周随叫随到的夜间次数，医生评定的EHR可用性与倦怠的几率独立相关，SUS评分每增加1分，倦怠的几率就降低3%（比值比，0.97; 95%CI，0.97-0.98; P
Objective: To describe and benchmark physician-perceived electronic health record (EHR) usability as defined by a standardized metric of technology usability and evaluate the association with professional burnout among physicians.Participants and Methods: This cross-sectional survey of US physicians from all specialty disciplines was conducted between October 12, 2017, and March 15, 2018, using the American Medical Association Physician Masterfile. Among the 30,456 invited physicians, 5197 (17.1%) completed surveys. A random 25% (n=1250) of respondents in the primary survey received a subsurvey evaluating EHR usability, and 870 (69.6%) completed it. EHR usability was assessed using the System Usability Scale (SUS; range 0-100). SUS scores were normalized to percentile rankings across more than 1300 previous studies from other industries. Burnout was measured using the Maslach Burnout Inventory.Results: Mean +/- SD SUS score was 45.9 +/- 21.9. A score of 45.9 is in the bottom 9% of scores across previous studies and categorized in the "not acceptable" range or with a grade of F. On multivariate analysis adjusting for age, sex, medical specialty, practice setting, hours worked, and number of nights on call weekly, physician-rated EHR usability was independently associated with the odds of burnout with each 1 point more favorable SUS score associated with a 3% lower odds of burnout (odds ratio, 0.97; 95% CI, 0.97-0.98; P