Researchers mine EHR metadata for clues to cut doctor burdens

With funding from the AMA, researchers across the country over the past six years have been able to delve into the plethora of data contained in EHRs to identify patterns that may contribute to physician burnout and thus hamper patient care.

The AMA’s EHR Use Research Grant program recently awarded nearly $360,000 for a new round of studies to take place in 2025, bringing to $2.6 million the total amount awarded since the program began in 2019. 

“The primary goal is to use the back-end data—the data that says how long you were on the EHR, what parts of the EHR you were using at any given time—and use that metadata to understand the current state and then to design interventions for a better future state,” said Christine Sinsky, MD, the AMA’s vice president of professional satisfaction.

This is early work in the field and these AMA grants are helping it to grow, Dr. Sinsky said.

“The more we understand and can optimize the care environment, the better the care patients will receive and the more time physicians can use the unique skills of their training for their patients,” she said. “When physicians can spend the majority of their day doing work for which they are uniquely capable, it’s good for patients, it’s good for the health care system and it’s really what drives professional satisfaction.”

From AI implementation to EHR adoption and usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors—not a burden.

Among other areas, the AMA-supported researchers will:

• Identify patient medical advice request factors linked to in-basket burden, burnout and cognitive load.
• Use EHR metadata from more than 200,000 physicians across more than 400 health systems to assess the impact of team-based EHR strategies on physician EHR burden, exploring how organizational team support may moderate the relationship.
• Explore Epic Signal data and surveys about physician experience to assess EHR and workflow predictors of primary care physicians’ intent to leave and intent to reduce clinical hours.
• Capture factors that contribute to post-shift EHR work for emergency physicians, going beyond just time measurement.
• Develop and validate a new measure of "schedule volatility" to indicate how much ambulatory physician schedules deviate from their intended plans.
• Identify key predictors of physician burnout and reduced quality of care using machine-learning techniques, assessing how work environments and leadership practices affect both outcomes. 

The latest round of grants will build on more than 30 studies published with the help of the AMA EHR Use Research Grant program.

For example, one study helped understand how much time physicians are spending on the EHR and how that changed over time. This study found that for every eight hours of patient-scheduled time, family physicians’ time on the EHR rose by 28 minutes and time on orders increased by 20 minutes from 2019 to 2023. Also, for every eight hours of patient-scheduled time, physicians spent 6.5 hours on the EHR, with 64 minutes daily spent entering orders.

“That converts into the capacity to deliver 50 million primary care visits a year across the country, if we were to assign those administrative tasks to another team member and free up that physician to see patients,” Dr. Sinsky said. 

Another study found that more than one-third of screening questions in federally qualified health centers were excessive, and that two-thirds of patients had excessive screens. Yet another study discovered the differences in the time that physicians in different specialties spent on the EHR, including how much time was spent on orders, the inbox and work outside of work. Primary care physicians, for example, spend three times more time on orders and inbox and twice as much time on after-hours work and total EHR time compared with their surgical colleagues.

Research like this can lead to health care organizations making changes that can boost physicians’ job satisfaction and increase the amount of time physicians have for patient care. 

Physician practices and health systems across the country are recognizing how the EHR and administrative tasks contribute to physician burnout and some have already implemented changes to reduce that burden. For example: 

• Confluence Health in North Central Washington made changes to reduce EHR workloads and saw their family physician burnout rate drop to 26%, down from 41%. 
• Geisinger uses augmented intelligence (AI) as one tool that has helped physicians focus on care by saving them about 500,000 hours in administrative burdens since 2019.
• The Permanente Medical Group saves physicians up to an hour every day with AI scribes.

Confluence Health, Geisinger and The Permanente Medical Group are members of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

“Physician burnout is driven by the recognition that we are spending our days doing the wrong work for our patients. The important work gets pushed to the side because of the mandatory administrative work,” Dr. Sinsky said. “The more we can more appropriately reduce the administrative work in the first place and then delegate much of the remaining tasks to team members, the better patient care will be because doctors will be able to give their patients more undivided attention.”

Learn more with the AMA STEPS Forward^® playbook on taming the EHR.