Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
J Am Med Inform Assoc. 2021 Apr 23;28(5):1051-1056. doi: 10.1093/jamia/ocab017.
Patient-generated health data (PGHD), such as patient-reported outcomes and mobile health data, have been increasingly used to improve health care delivery and outcomes. Integrating PGHD into electronic health records (EHRs) further expands the capacities to monitor patients' health status without requiring office visits or hospitalizations. By reviewing and discussing PGHD with patients remotely, clinicians could address the clinical issues efficiently outside of clinical settings. However, EHR-integrated PGHD may create a burden for clinicians, leading to burnout. This study aims to investigate how interactions with EHR-integrated PGHD may result in clinician burnout. We identify the potential contributing factors to clinician burnout using a modified FITT (Fit between Individuals, Task and Technology) framework. We found that technostress, time pressure, and workflow-related issues need to be addressed to accelerate the integration of PGHD into clinical care. The roles of artificial intelligence, algorithm-based clinical decision support, visualization format, human-computer interaction mechanism, workflow optimization, and financial reimbursement in reducing burnout are highlighted.
患者生成的健康数据（PGHD），如患者报告的结果和移动健康数据，已被越来越多地用于改善医疗保健的提供和结果。将 PGHD 整合到电子健康记录（EHR）中，进一步扩大了在不需要门诊或住院的情况下监测患者健康状况的能力。通过远程查看和与患者讨论 PGHD，临床医生可以在临床环境之外有效地解决临床问题。然而，EHR 整合的 PGHD 可能会给临床医生带来负担，导致 burnout。本研究旨在探讨与 EHR 整合的 PGHD 交互如何导致临床医生 burnout。我们使用经过修改的 FITT（个体、任务和技术之间的匹配）框架来确定导致临床医生 burnout 的潜在因素。我们发现，需要解决技术压力、时间压力和与工作流程相关的问题，以加速将 PGHD 整合到临床护理中。强调了人工智能、基于算法的临床决策支持、可视化格式、人机交互机制、工作流程优化和财务报销在减少 burnout 方面的作用。
