Physician Burnout in the Electronic Health Record Era

TO THE EDITOR: Downing and colleagues (1) note that changing the current unnecessary and burdensome clinical documentation requirements in the United States will go a long way in reducing physician burnout. At the same time, much can be done to modify EHRs and their associated infrastructure to reduce the strain on physicians. Years down the road, I would not be surprised to see an epidemic of musculoskeletal injuries in health care workers ranging from carpal tunnel syndrome to degenerative joint disease of the cervical spine due to spending hours at a desk, glaring into a monitor, clicking repeatedly on a mouse, and continuously typing on a keyboard. The effect of light exposure at certain times of the day on circadian rhythm and its consequences on health are well known. As such, I also would not be surprised to see such changes in physicians and other health care providers who use computers late in the evening to try to catch up with their notes. Vendors of EHRs need to start paying more attention to the actual design of their product, which is clunky and needs a substantial overhaul. The EHR interface should be fundamentally based on touchscreen and voice technology, easy to navigate, and highly customizable by individual physicians to meet their particular needs. Hardware manufacturers should develop and incorporate ergonomic solutions directly into their devices, which should be more robust with better processing power. Resolution of computer screens needs to be improved. Reducing emission of harmful light frequencies by such devices is important, and touchscreen technology needs to be more resilient. Network speeds could also be increased, and the delay in accessing patient data is unacceptable and needs to change. These challenges could create opportunities for such companies as Apple, Google, and Microsoft to enter the EHR arena and build a product with higher-quality software and hardware. The time is right for such innovation, and national medical organizations should aid, encourage, collaborate on, and incentivize such efforts. Meanwhile, physicians should demand compensation for the many hours they have to spend after work to complete their documentation because of a system that is rudimentary and inefficient.