EMR FAILS and a Dose Response Curve for Physician Burnout Revealed

Posted by Dike Drummond MD

emr-electronic-medical-record-dose-response-curve-physician-burnout-usability-OPT-150WThe adoption of the Electronic Medical Record is a clear and obvious cause of physician burnout.

This new study provides three new data points for both providers and healthcare leaders:

  • Evidence of a dose response curve between EMR exposure and physician burnout
  • Objective measurements of EMR usability compared to other unpopular software programs.
  • And an actual letter grade from physicians for EMRs as a group.
    (No surprise here - EMR gets a big fat "F"

This is all an avoidable tragedy
EMR should have never been a major burnout cause 
It should have been a simple staffing issue

We consider this paper a MUST READ for all C-Suite Healthcare leaders, Chief Wellness Officers and Wellness Champions

We read the study so you don't have to!
Highlights and commentary below --

This is Blog Post #313
Complete Blog Library  is Here

Study Highlights

The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians” by Edward R. Melnick, MD, MHS; Liselotte N. Dyrbye, et al -- 14 November 2019, 
Mayo Clinic Proceedings. DOI: 10.1016/j.mayocp.2019.09.024

A study of the correlation between

  • Physician Burnout as measured by the Maslach Burnout Index (MBI)

  • And EMR usability as rated by the same physicians

Just what is the System Usability Scale?

Great question and here is the authors' reply:

"... the System Usability Scale (SUS) is favored as an industry standard as a short, simple, and reliable measurement of technology usability with solid benchmarks to easily interpret its scores.

For example, a Google search has a SUS score of 93, which ranks in approximately the top 0.01% of technologies evaluated using the SUS and can be described as being in the acceptable range with a usability grade of A."


Participant N = 870

30,456 physicians - from all specialties - were invited to participate in a burnout screening survey
5197 responded (17%)
Of those, a random 25% (1250) were invited to participate in the SUS EMR Usability Survey
870 physicians completed all items of both surveys
Demographic analysis shows this group to be generally representative of US physicians



45.9% of survey responders had "at least 1 symptom of burnout" as measured by the Maslach Burnout Inventory (MBI).

EMR Usability

"Among the 870 physicians evaluating their EHR’s usability, mean SD SUS score was 45.9. A score of 45.9 is in the bottom 9% of usability scores across studies in other industries and is categorized in the not acceptable” range or with a grade of “F"."


Just to set some context, the lowest rated popular computer program with regards to usability -- is Microsoft Excel with an SUS = 57.

The physicians in this study ranked their EMR a 45. Here is a graph by Michael S. Helfenbein over at SciTechDaily showing common comparisons.



In addition:

Older physicians were more likely to rate EMR as less usable. (P=.007)

Physicians working in academic medical centers rated their EMR less favorably. (P=.002)


Dose response curve

Quoting the authors:
"EHR usability scores were strongly and independently associated with physician burnout in a dose-response relationship. The odds of burnout were lower for each 1 point more favorable SUS score, a finding that persisted after adjusting for an extensive array of other personal and professional characteristics."

What do the study author's recommend as an action step?

The authors go out on a limb here:
"Given the association between EHR usability and physician burnout, improving EHR usability may be an important approach to help reduce health care professional burnout."

That is some pretty bold and decisive stuff right there.


Here is our second opinion:
The time for more studies is over!

With 175 client's worth of experience, we can tell you the study's recommendation is dead wrong.

It is simple to disconnect EMR from Physician Burnout.
You can accomplish this feat tomorrow if you wish.
All you have to do is ...


Here are three links with specific details on how to stop physician burnout and improve documentation in one swell foop. 

Click one
- learn a whole new approach to this issue -
and contact us using this link for clear directions on how to get started.



Where does your EMR rank in the usability of the common computer programs you use every day?
Do you have one or more scribes or super MA's?
What difference has that made to your daily stress and burnout levels?



Tags: EMR, stop physician burnout