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Cited by 65Technostress in Professional SettingsElectronic Health Records SystemsHealthcare professionals’ stress and burnout

Findings and guidelines on provider technology, fatigue, and well-being: scoping review

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Hilty, Donald M, Armstrong, Christina M, Smout, Shelby A, Crawford, Allison, Maheu, Marlene M, Drude, Kenneth P, Chan, Steven, Yellowlees, Peter M +1 more·2022·Journal of Medical Internet Research
DOI 10.2196/34451PMC PMC9178447

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Abstract

Background: Video and other technologies are reshaping the delivery of health care, yet barriers related to workflow and possible provider fatigue suggest that a thorough evaluation is needed for quality and process improvement. Objective: This scoping review explored the relationship among technology, fatigue, and health care to improve the conditions for providers. Methods: A 6-stage scoping review of literature (from 10 databases) published from 2000 to 2020 that focused on technology, health care, and fatigue was conducted. Technologies included synchronous video, telephone, informatics systems, asynchronous wearable sensors, and mobile health devices for health care in 4 concept areas related to provider experience: behavioral, cognitive, emotional, and physical impact; workplace at the individual, clinic, hospital, and system or organizational levels; well-being, burnout, and stress; and perceptions regarding technology. Qualitative content, discourse, and framework analyses were used to thematically analyze data for developing a spectrum of health to risk of fatigue to manifestations of burnout. Results: Of the 4221 potential literature references, 202 (4.79%) were duplicates, and our review of the titles and abstracts of 4019 (95.21%) found that 3837 (90.9%) were irrelevant. A full-text review of 182 studies revealed that 12 (6.6%) studies met all the criteria related to technology, health care, and fatigue, and these studied the behavioral, emotional, cognitive, and physical impact of workflow at the individual, hospital, and system or organizational levels. Video and electronic health record use has been associated with physical eye fatigue; neck pain; stress; tiredness; and behavioral impacts related to additional effort owing to barriers, trouble with engagement, emotional wear and tear and exhaustion, cognitive inattention, effort, expecting problems, multitasking and workload, and emotional experiences (eg, anger, irritability, stress, and concern about well-being). An additional 14 studies that evaluated behavioral, emotional, and cognitive impacts without focusing on fatigue found high user ratings on data quality, accuracy, and processing but low satisfaction with clerical tasks, the effort required in work, and interruptions costing time, resulting in more errors, stress, and frustration. Our qualitative analysis suggests a spectrum from health to risk and provides an outline of organizational approaches to human factors and technology in health care. Business, occupational health, human factors, and well-being literature have not studied technology fatigue and burnout; however, their findings help contextualize technology-based fatigue to suggest guidelines. Few studies were found to contextually evaluate differences according to health professions and practice contexts. Conclusions: Health care systems need to evaluate the impact of technology in accordance with the Quadruple Aim to support providers’ well-being and prevent workload burden, fatigue, and burnout. Implementation and effectiveness approaches and a multilevel approach with objective measures for clinical, human factors, training, professional development, and administrative workflow are suggested. This requires institutional strategies and competencies to integrate health care quality, technology and well-being outcomes.

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  • Such withdrawal can disrupt established workflows, reduce confidence in the stability of digital initiatives, reduce trust in managerial decisions and create uncertainty about the longevity or scope of future innovations.

    “Such withdrawal can disrupt established workflows, reduce confidence in the stability of digital initiatives, reduce trust in managerial decisions and create uncertainty about the longevity or scope of future innovations.”

    From Radiology staff perspectives after decommissioning an artificial intelligence (AI) tool for expedited lung cancer triage (2026) · cites this paper as [6]

    The Introduction (Background) discusses integrating technology into workflows, and the Results (Organizational Responses) discusses adjusting workflows through change management. Neither addresses the withdrawal of a digital initiative or its claimed effects on confidence, managerial trust, or uncertainty about future innovations. Searches for withdrawal, discontinuation, stability, and trust did not locate a passage supporting those effects. (LLM, conf=0.74)

    Experimental — accuracy not yet measured

  • Repeated cycles of short-term pilots could reduce staff willingness to engage with future digital investment projects.

    “Staff witness care quality decline for administrative purposes outside their control which could mean that repeated cycles of short-term pilots could reduce their willingness to engage with future digital investment projects.”

    From Radiology staff perspectives after decommissioning an artificial intelligence (AI) tool for expedited lung cancer triage (2026) · cites this paper as [6]

    The Introduction (Background) discusses technology-related fatigue, and the Results discuss provider engagement, but neither links repeated short-term pilots to willingness to join future digital projects. Searches for pilots, short-term projects, and change fatigue found no passage addressing that link. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Hilty, D. M., Armstrong, C. M., Smout, S. A., Crawford, A., Maheu, M. M., Drude, K. P., Chan, S., Yellowlees, P. M., & Krupinski, E. A.
Affiliations
  • VA Northern California Health Care System (US)
  • United States Department of Veterans Affairs (US)
  • Virginia Commonwealth University (US)
  • Centre for Addiction and Mental Health (CA)
  • VA Palo Alto Health Care System (US)
  • University of California Davis Medical Center (US)
  • Emory University (US)
Corresponding author
Hilty, Donald M
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2022-05-25
Volume
24
Issue
5
Pages
e34451
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/34451
PMC
PMC9178447
OpenAlex
W4282936433
Cited by
65
References
13
Citations by year
2026: 19 · 2025: 20 · 2024: 10 · 2023: 13 · 2022: 3
FWCI
1.63
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
U.S. Department of Veterans Affairs
Topics
  • Social Sciences › Psychology › Social Psychology › Technostress in Professional Settings
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
Keywords
burnout, electronic health records, wearable sensors, mobile health devices, telemedicine, workflow barriers, occupational stress, human factors, provider workload, visual fatigue, neck pain, telehealth evaluation, telehealth implementation
MeSH terms
Burnout, Professional, Delivery of Health Care, Humans, Technology, Workplace, Telemedicine

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