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Electronic medical records and physician stress in primary care: results from the MEMO Study
Open accessAbstract
BACKGROUND: 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.
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From Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review (2021) · cites this paper as [41]
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Metadata
- Authors
- Babbott, S., Manwell, L. B., Brown, R., Montague, E., Williams, E., Schwartz, M., Hess, E., & Linzer, M.
- Affiliations
- University of Kansas Medical Center (US)
- University of Wisconsin–Madison (US)
- Northwestern University (US)
- University of Alabama (US)
- New York University (US)
- Mayo Clinic (US)
- Hennepin County Medical Center (US)
- Corresponding author
- Babbott, Stewart
- ORCID
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-02
- Volume
- 21
- Issue
- e1
- Pages
- e100-e106
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC3957395
- OpenAlex
- W2152304691
- Cited by
- 366
- References
- 29
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 27 · 2023: 24 · 2022: 23 · 2021: 48 · 2020: 61 · 2019: 57 · 2018: 26 · 2017: 37 · 2016: 17 · 2015: 13 · 2014: 9
- FWCI
- 22.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Medical Informatics Association (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (R01 HS 011955, 5R01 HS 011955)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Technostress in Professional Settings
- Keywords
- electronic health records, physician stress, burnout, physician satisfaction, primary care physicians, time pressure, job redesign
- MeSH terms
- Adult, Burnout, Professional, Female, Humans, Job Satisfaction, Male, Middle Aged, Physicians, Family, Primary Health Care, Stress, Psychological, Organizational Culture, Electronic Health Records, Physicians, Primary Care
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