The complex case of EHRs: examining the factors impacting the EHR user experience
Open accessAbstract
Physicians can spend more time completing administrative tasks in their electronic health record (EHR) than engaging in direct face time with patients. Increasing rates of burnout associated with EHR use necessitate improvements in how EHRs are developed and used. Although EHR design often bears the brunt of the blame for frustrations expressed by physicians, the EHR user experience is influenced by a variety of factors, including decisions made by entities other than the developers and end users, such as regulators, policymakers, and administrators. Identifying these key influences can help create a deeper understanding of the challenges in developing a better EHR user experience. There are multiple opportunities for regulators, policymakers, EHR developers, payers, health system leadership, and users each to make changes to collectively improve the use and efficacy of EHRs.
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For EHR interventions, user experience depends on regulatory, organizational, and vendor priorities rather than those of users, particularly when users are residents who frequently rotate on and off service.
“This imperative is especially important for electronic health record (EHR) interventions, for which the user experience depends on regulatory, organizational, and vendor priorities rather than those of users, particularly when users are residents who are frequently rotating on and off service (5).”
From Cocreating the ICU-PAUSE Tool for Intensive Care Unit–Ward Transitions (2022) · cites this paper as [5]
The EHR USER EXPERIENCE section (page not provided) says that decisions by regulators, healthcare organizations, and vendors affect users’ experience, including factors outside users’ control. The EHR VENDOR INFLUENCES section adds that many products were designed for billing and regulatory requirements rather than clinician use. The paper does not address residents rotating on and off service, and it does not say that user priorities have no influence. (LLM, conf=0.87)
Experimental — accuracy not yet measuredEHR notes and tools are often designed with minimal or no end-user input.
“These benefits are particularly salient for tools to support EHR notes and tools, which are frequently both over- and underdesigned at the same time (17, 18) and are often designed with minimal or no end-user input (5).”
From Cocreating the ICU-PAUSE Tool for Intensive Care Unit–Ward Transitions (2022) · cites this paper as [5]
The EHR VENDOR INFLUENCES section says it is not uncommon for clinicians to be absent from vendor-product usability testing and that many EHR products were designed around billing and payer requirements rather than clinician use. This supports the concern about limited end-user involvement, but it does not establish how often EHR note tools specifically are designed with minimal or no end-user input. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSurvey respondents may conflate their EHR usability with the burdens of documentation due to regulatory, clerical, or administrative requirements or local implementation that manifest in the EHR.
“Fourth, survey respondents may conflate their EHR usability with the burdens of documentation due to regulatory, clerical, or administrative requirements or local implementation that manifest in the EHR (eg, individual proficiency).12,36,37”
From The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians (2020) · cites this paper as [36]
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- Authors
- Tutty, M. A., Carlasare, L. E., Lloyd, S., & Sinsky, C. A.
- Affiliations
- American Medical Association (US)
- Corresponding author
- Tutty, Michael A
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-04-02
- Volume
- 26
- Issue
- 7
- Pages
- 673-677
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC6562154
- OpenAlex
- W2928914367
- Cited by
- 94
- References
- 37
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 16 · 2023: 13 · 2022: 17 · 2021: 15 · 2020: 12 · 2019: 2
- FWCI
- 12.55
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of the American Medical Informatics Association (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
- Keywords
- electronic health records, physician burnout, administrative burden, EHR design, health information technology regulation, health policy, health system leadership, EHR adoption
- MeSH terms
- Health Information Interoperability, Burnout, Professional, Delivery of Health Care, Humans, Physicians, United States, Government Regulation, Electronic Health Records
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