Burnout Related to Electronic Health Record Use in Primary Care
Open accessAbstract
Physician burnout has been increasing in the United States, especially in primary care, and the use of Electronic Health Records (EHRs) is a prominent contributor. This review article summarizes findings from a PubMed literature search that shows the significant contributors to EHR-related burnout may be documentation and clerical burdens, complex usability, electronic messaging and inbox, cognitive load, and time demands. Documentation requirements have escalated and have inherently changed from paper-based records. Many clerical tasks have also shifted to become additional physician responsibilities. When considering factors of efficiency, effectiveness, and user satisfaction, EHRs overall have an inferior usability score when compared to other technologies. The volume and organization of data along with alerts and complex interfaces require a substantial cognitive load and result in cognitive fatigue. Patient interactions and work-life balances are negatively affected by the time requirements of EHR tasks during and after clinic hours. Patient portals and EHR messaging have created a separate source of patient care outside of face-to-face visits that is often unaccounted productivity and not reimbursable.
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Cognitive load must be managed for effective problem-solving and clinical decision-making, as levels of cognitive load influence decisions and outcomes.
“Cognitive load must be managed for effective problem-solving and clinical decision-making (correct decisions/reduction of errors), as levels of cognitive load influence decisions and outcomes38,49–53.”
From When better data meets better design: How EHR data usability and system usability shape physicians' cognitive load (2026) · cites this paper as [53]
The Results section (‘Cognitive Load’; page not supplied) says EHR information overload can obscure critical clinical information and that processing alerts places cognitive demands on clinical decisions. It does not establish that managing cognitive load improves problem-solving or reduces errors, or that different load levels determine decisions and outcomes. (LLM, conf=0.83)
Experimental — accuracy not yet measuredAdministrative tasks, including reviewing and responding to EHR inbox messages, are often time consuming and not reimbursable, and have been linked to clinician burnout, especially among female providers.
“Administrative tasks, including reviewing and responding to EHR inbox messages from patients, are often time consuming and not reimbursable, and have been linked to clinician burnout, 33 especially among female providers.”
From Wearable Devices, Health Care Use, and Psychological Well-Being in Patients With Atrial Fibrillation (2024) · cites this paper as [33]
The Results section, “Electronic Messaging and Inbox” (page unavailable), describes inbox work as burdensome, typically unreimbursed, and associated with burnout. The provided passages and searches for female providers and gender do not support the claim that the association is especially strong among female providers. (LLM, conf=0.87)
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- Authors
- Budd, J.
- Affiliations
- University of Florida Health (US)
- Corresponding author
- Budd, Jeffrey
- ORCID
- Budd, Jeffrey
- Venue
- Journal of Primary Care & Community Health
- Publisher
- SAGE Publications
- Published
- 2023-01
- Volume
- 14
- Pages
- 21501319231166921-21501319231166921
- ISSN
- 2150-1319 (ISSN-L)
- 2150-1327
- PMC
- PMC10134123
- OpenAlex
- W4366350958
- Cited by
- 223
- References
- 46
- Citations by year
- 2026: 80 · 2025: 85 · 2024: 51 · 2023: 7
- FWCI
- 8.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Primary Care & Community Health (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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
- physician burnout, electronic health records, primary care, clinical documentation burden, clerical work, EHR usability, cognitive load, mental fatigue, patient portals, work-life balance, productivity, reimbursement
- MeSH terms
- Burnout, Professional, Documentation, Humans, Physicians, Primary Health Care, United States, Electronic Health Records
About these checks
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