Objective

To describe and benchmark physician-perceived electronic health record (EHR) usability as defined by a standardized metric of technology usability and evaluate the association with professional burnout among physicians.

Participants and Methods

This cross-sectional survey of US physicians from all specialty disciplines was conducted between October 12, 2017, and March 15, 2018, using the American Medical Association Physician Masterfile. Among the 30,456 invited physicians, 5197 (17.1%) completed surveys. A random 25% (n=1250) of respondents in the primary survey received a subsurvey evaluating EHR usability, and 870 (69.6%) completed it. EHR usability was assessed using the System Usability Scale (SUS; range 0-100). SUS scores were normalized to percentile rankings across more than 1300 previous studies from other industries. Burnout was measured using the Maslach Burnout Inventory.

Results

Mean ± SD SUS score was 45.9±21.9. A score of 45.9 is in the bottom 9% of scores across previous studies and categorized in the “not acceptable” range or with a grade of F. On multivariate analysis adjusting for age, sex, medical specialty, practice setting, hours worked, and number of nights on call weekly, physician-rated EHR usability was independently associated with the odds of burnout with each 1 point more favorable SUS score associated with a 3% lower odds of burnout (odds ratio, 0.97; 95% CI, 0.97-0.98; P<.001).

Conclusion

The usability of current EHR systems received a grade of F by physician users when evaluated using a standardized metric of technology usability. A strong dose-response relationship between EHR usability and the odds of burnout was observed.

中文翻译：

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美国医师对电子病历的感知可用性与职业倦怠之间的关联。

客观的

描述和基准化由技术可用性的标准化度量定义的医生感知的电子健康记录（EHR）可用性，并评估与医生之间职业倦怠的关联。

参加者和方法

这项跨学科的调查是在2017年10月12日至2018年3月15日期间使用美国医学会医师主档案对所有专业学科的美国医师进行的。在30,456名受邀医师中，有5197名（17.1％）完成了调查。在主要调查中，随机有25％（n = 1250）的受访者接受了评估EHR可用性的子调查，并且有870（69.6％）完成了该调查。使用系统可用性量表（SUS；范围0-100）评估EHR可用性。在其他行业的1300多项先前研究中，将SUS分数标准化为百分位排名。使用Maslach倦怠量表测量倦怠。

结果

平均值±SD SUS评分为45.9±21.9。在以前的研究中，得分最低的9％（45.9分）被归类为“不可接受”范围或F级。在对年龄，性别，医学专业，执业环境，工作时间和工作时间进行调整的多变量分析中每周电话待诊的夜晚数，医生评估的EHR可用性与倦怠几率独立相关，每提高1点SUS得分就越好，并且倦怠几率降低3％（赔率，0.97； 95％CI，0.97-0.98 ; P <.001）。

结论

当使用标准的技术可用性指标进行评估时，当前的EHR系统的可用性被医师用户评为F级。观察到EHR可用性和倦怠几率之间存在很强的剂量反应关系。