Physician Stress During Electronic Health Record Inbox Work: In Situ Measurement With Wearable Sensors

• DOI: 10.2196/24014
• Publication Date: 2021-04-28T15:18:08Z
• Authors: Fatema Akbar; Gloria Mark; Stephanie Prausnitz; E Margaret Warton; Jeffrey A East; Mark F Moeller; Mary E Reed; Tracy A Lieu
• Keywords: Occupational Stress

Background Increased work through electronic health record (EHR) messaging is frequently cited as a factor of physician burnout. However, studies to date have relied on anecdotal or self-reported measures, which limit the ability match EHR use patterns with continuous stress throughout day. Objective The aim this study collect and physiologic data unobtrusive means that provide objective cluster distinct inbox work, identify physicians’ daily patterns, evaluate association between stress. Methods Physicians were recruited from 5 medical centers. Participants (N=47) given wrist-worn devices (Garmin Vivosmart 3) heart rate sensors wear for 7 days. measured physiological day based variability (HRV). Perceived was also self-reports experience sampling one-time survey. From system logs, time attributed different activities quantified. By using clustering algorithm, identified their associated measures compared. effects examined generalized linear mixed model. Results spent an average 1.08 hours doing out total 3.5 hours. Patient messages accounted most (mean 37%, SD 11%). A 3 emerged: mostly outside hours, during extending after contiguous Across these groups, showed periods in increased: first hour early afternoon, evening. group 1 had longest duration (80 243 min valid HRV data; P=.02), by sensors. Inbox duration, window switching (moving one screen another), proportion done batching, week each independently (marginal R2=15%). Individual-level random significant explained variation (conditional R2=98%). Conclusions This among demonstrate associations We potentially modifiable factors stress: switching, Organizations seeking reduce may consider system-based changes incorporation management into