EHR Fatigue

Electronic health records (EHR) are supposed to improve quality. While EHRs certainly are highly useful for information sharing, they may have adverse consequences. One issue may be that EHRs may induce fatigue in physicians and sap their needed energy/concentration away from their primary task: caring for patients.

To test whether EHRs increase physician fatigue and impact efficiency, a paper by Khairat et al. (2020) looked at ICU physician use of EHR. The authors test for fatigue using pupillometry and efficiency, using metrics such as mouse clicks, time, and number of EHR screens needed to complete a task. They find:

All physician participants experienced physiological fatigue at least once during the exercise, and 20 of 25 participants (80%) experienced physiological fatigue within the first 22 minutes of EHR use. Physicians who experienced EHR-related fatigue in 1 patient case were less efficient in the subsequent patient case, as demonstrated by longer task completion times (r = −0.521; P = .007), higher numbers of mouse clicks (r = −0.562; P = .003), and more EHR screen visits (r = −0.486; P = .01).

In short, while EHR are useful, the benefits for mandating additional physician record keeping need to be weighed by the cost of these tasks, which will include not just physician time cost but also its impact on physician fatigue.

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