After-hours charting significantly associated with physician burnout

A study published this week in the Journal of the American Medical Informatics Association found that less after-hours charting was associated with lower burnout scores.  

The study, which relied on survey responses from more than 25,000 physicians, found that satisfaction with organizational EHR support was also significantly associated with lower levels of burnout overall.  

“EHR factors are not solely responsible for after-hours charting, and other efforts besides EHR improvements, such as team documentation and new approaches to care team models for clinical support, may reduce after-hours charting,” noted the researchers.  


Physician burnout is a serious problem in the medical industry, associated with poor clinical care, medical mistakes and caregiver attrition. Researchers estimate its economic impact at $4.6 billion each year.  

For this JAMIA study, the research team used data from the KLAS Arch Collaborative to analyze the links between self-reported burnout and after-hours charting, as well as organizational EHR support.  

They found that physicians who reported five or fewer hours of after-hours charting were twice as likely to report lower burnout scores, compared to those charting six or more hours.   

This was true for most physician specialties, but the odds were highest for OB-GYNs and pediatricians.  

Meanwhile, researchers found that those physicians who agreed that their organization has done a great job with EHR implementation, training and support were significantly more likely to report lower levels of burnout for all physician specialties, with the highest-odds ratios for cardiology and neurology.  

Researchers also observed variation in burnout by specialty.    

In this study, the specialties with the highest burnout levels were family medicine, hematology/oncology, internal medicine, pulmonology, neurology and cardiology. Those with the lowest burnout levels were psychiatry, anesthesiology, orthopedics, hospital medicine and gastroenterology.  

The team noted that their sample disproportionately features physicians from health systems and organizations using the Epic EHR system. 

“Despite these limitations, this study provides new insights into factors associated with physician burnout and highlights areas for future research,” they wrote.  


The association between burnout and EHR use has been increasingly interrogated in recent months, with the COVID-19 pandemic exacerbating existing issues with health IT in the clinical space.   

And it’s not just physicians: A study published earlier this week found that nurses also gave EHR usability a failing grade – and that poor usability ratings are associated with higher levels of burnout.   


“Our findings suggest that EHR interventions focused on improving organizational EHR support could help reduce physician burnout regardless of the time physicians spend on after-hours charting,” wrote the researchers in the JAMIA study.


Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.

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