It’s a mixed bag. The use of technology is increasing in the healthcare setting.
On the one hand, technological innovations such as electronic health records — which are now available in approximately 90%Open in the new window of all U.S. Medical practices — allow for faster access to patient files.
Greater use of technology in the medical setting can also be problematic for those who are expected to make use of it. Healthcare workers may be frustrated by non-user-friendly interfaces or frequent updates. Electronic records can be time-consuming for practitioners. Outpatient physicians spend two times as much time (open in a new window) on electronic records than they do with their patients.
The double-edged blade of healthcare technology interests Mohsen Baati, an associate professor of operations information and technology at Stanford Graduate School of Business, and Daniel Tawfikopen New Window, an instructor of pediatrics at Stanford School of Medicine.
Bayati explains that “Technology innovation offers many benefits. For example, it allows for the understanding of digital “signatures” of a patient’s health in order to determine their treatment. The same systems can lead to burnout or emotional exhaustion among healthcare providers, increasing the chances of human error.
Burnout is a problem that affects thousands of healthcare workers in the U.S. and costs up to $6 billion per year.
In order to understand the relationship between frustration with technology and burnout among healthcare workers, Tawfik and Bayati, along with other collaborators at Stanford (Amrita sharpen in a new window, a pediatrics fellow, Tait Shanafeltopen, opened a new window a professor in hematology, and Jochen, profit open in a new window an associate professor in pediatrics) as well as Duke University In a recent paper they found that a third or more of health care workers expressed frustration with technology, this frustration contributed significantly to burnout.
Large-Scale Survey
Researchers analyzed data collected from an email survey conducted in 2015 among over 15,000 health workers at 31 Michigan hospitals. The most common occupation (28%) was nurse, followed by technician (12%) and administrative support (12%).
The survey asked questions to measure emotional exhaustion or burnout, as well as “work-life balance.” Tawfik says that the integration questions probed how people deal with conflicts between work life and personal life, such as missing meals or coming home late.
This question was of particular interest: “How often have you felt frustrated by technology in the last week?” The respondents were not asked to define the term “technology” but rather allowed them to interpret it themselves.
Tawfik says, “It might have been anything from looking up labs results in electronic records to entering vitals or any other assessments or orders in the records.” It’s an important part of their day.
Researchers used regression analysis and machine learning techniques to determine the independent effects of each integration factor for workers who were surveyed. This was done after controlling for many potential confounding variables.
A Universal Concern
The study revealed that frustration with technology is a common complaint among healthcare workers. It also correlated strongly with emotional exhaustion.
Three-quarters of respondents said they felt frustrated by technology at least three days per week. Burnout is primarily caused by difficulty sleeping. However, frustration with technology comes in second. For every 10 points on a scale of 100, a respondent who said they were more frustrated with technology had a 1.2-point increase in their burnout score. Tawfik said, “That is a strong correlation.” It’s independent of all other indicators, such as work-life balance and workload.
Burnout is a common problem among all types of healthcare workers. Tawfik explains that “about half of our respondents work in direct clinical care – doctors, nurses, respiratory therapy therapists – and the other half in indirect care – administrative support, custodians, etc. The relationships were almost identical in all groups, regardless of their actual roles. It seems like people are experiencing a human experience.
An analysis of survey responses across various healthcare settings, including physician groups, billing departments, and clinics, revealed that technology frustration was present in all sectors but varied by individual. Tawfik explains: “We looked at more than 1,000 work settings and found some people who were frustrated and others who weren’t.” It was a matter of the interaction between an individual and technology.
Bayati and Tawfik point out that this research is an observational study and is the first step in establishing a causal relationship. They say that the findings are important for the healthcare domain.
Battle Burnout
The research has a positive, practical implication. It shows that the technology used by many workers is already adequate.
It’s more likely to be about understanding what each worker needs. Tawfik says that changing the technology would be costly and cause more frustration. “People who feel frustrated might need some more training or tips on how they can be more efficient. Maybe they should re-evaluate what technology can offer.
Bayati states that “more efforts are needed to minimize highly repetitive clerical duties that current health care technology requires, and AI could be used to automate these small tasks.” As part of the Affordable Health Care Act, government incentives facilitated adoption. The same approach can be used to encourage key stakeholders to reduce frustrations with health care technology.”
The next phase of the research on the connection between technology and burnout will inform strategies for solutions. Tawfik says, “This was an overall study.” The next two questions are about what it is about technology or the interaction with technology that predicts burnout. We can develop interventions to help people interact more effectively with technology once we better understand these mechanisms.
Tawfik, for example, is studying the factors that contribute to frustration with electronic health records. This includes how much time people spend working on these records and whether this affects their efficiency in patient care and their burnout level. He also wants to know how employees are writing their notes: “Are workers typing them?” Dictating? Copying-pasting? “What we learn may help us to develop better note-writing techniques that can benefit individuals as well.”