Department of Pediatrics, Division of General Pediatrics, Boston Children's Hospital, Massachusetts, USA.
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
J Am Med Inform Assoc. 2020 Apr 1;27(4):644-646. doi: 10.1093/jamia/ocz222.
The rise of clinician burnout has been correlated with the increased adoption of electronic health records (EHRs). Some vendors have used data entry logs to measure the amount of time spent using the EHR and have developed metrics of provider efficiency. Initial attempts to utilize these data have proven difficult as it is not always apparent whether variations reflect provider behavior or simply the metric definitions. Metric definitions are also updated intermittently without warning, making longitudinal assessment problematic. Because the metrics are based on proprietary algorithms, they are impossible to validate without costly time-motion studies and are also difficult to compare across institutions and vendors. Clinical informaticians must partner with vendors in order to develop industry standards of EHR use, which could then be used to examine the impact of EHRs on clinician burnout.
临床医生 burnout 的增加与电子健康记录 (EHR) 的广泛采用有关。一些供应商使用数据录入日志来衡量使用 EHR 的时间，并开发了提供者效率的指标。最初尝试利用这些数据证明是困难的，因为并不总是清楚变化是反映提供者的行为还是仅仅是指标定义。指标定义也会不定期更新，没有警告，使得纵向评估变得困难。由于这些指标是基于专有算法的，因此如果不进行昂贵的时间-动作研究，就不可能对其进行验证，而且在不同机构和供应商之间也很难进行比较。临床信息学家必须与供应商合作，制定 EHR 使用的行业标准，然后可以利用这些标准来检查 EHR 对临床医生 burnout 的影响。
