Reduction in EHR Inbox Notifications Not Enough to Cut Clinician Burnout

Original Article by
Posted on January 16th, 2023 by Hannah Nelson

Collaboration between health system leaders and primary care providers is necessary to address clinician burnout brought on by EHR inbox notifications.

Reducing EHR inbox notifications in the primary care setting did not have a measurable effect on clinician burnout, according to a study published in AJMC.

In 2017, the Veterans Health Administration (VHA) led an initiative to reduce low-value EHR inbox notifications. Each facility formatted its EHR to include a mandatory set of notifications based on VHA and facility priorities and trained PCPs in EHR customization of optional notifications.

Researchers estimated the share of PCPs experiencing clinician burnout using VHA All Employee Survey responses before and after the initiative in 2016 and 2018. The study aggregated survey responses from 6,459 PCPs at 138 VHA facilities.

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For instance, the initiative emphasized reducing duplicative notifications and notifications that required reading time but not additional PCP actions, which may not have been time intensive.

“Notification volume alone may be a poor measure of the actual effort required for inbox management,” the researchers wrote. “Although substantial increases and decreases in notification volume may reflect improved EHR utilization, changes in notification volume may not have influenced aspects of EHR-related workload that are predictive of burnout.”

“Assessment of notification type, value, and cognitive burden may improve measures of EHR notification burden, which may then be associated with burnout,” they continued. “Further work is needed to understand how time spent on low-value notifications and sufficient work time to respond to notifications can influence PCP fatigue and burnout.”

The researchers said health systems should collaborate with providers to address clinician burden through EHR optimization.

“PCPs spend more time on inbox messaging than do clinicians in other medical or surgical specialties, and interventions reducing EHR work burden should consider PCPs’ specific needs,” the study authors wrote. “Collaboration between health system leaders and PCPs on EHR design, with a focus on staff well-being, is essential.”