Study: EHR use, productivity tied to physician turnover

Physicians who are less tuned into EHR may be more likely to leave their employer, according to a study.

The study, which appears on JAMA Open Network, looks at the association of physician productivity and EHR use patterns with physician turnover. It looked at 314 non-teaching ambulatory physicians from March 2018 to February 2020 based on five core measures of EHR use: total EHR time, work outside of clinical hours, encounter note documentation, active time on inbox, and teamwork for orders.

The study also looked at physician productivity measures were also analyzed as part of the study to account for differences in clinical workload such as patient volumes, intensity of work, and demand for physician services.

After controlling for physician age, gender, medical specialty, and study month, the analysis found that the variables associated with physician departure were: time on inbox, teamwork, demand, and age 45 to 54 years versus 25 to 34. In a secondary model, total EHR time was also found to be associated with physician turnover, according to the study.

Specifically, the study found that reduced time on EHR and inbox were tied to physician departure.

“The direction of the association between these time-based EHR use metrics and physician departure was opposite of the hypothesized direction based on assumptions about the association between EHR usability and physician burnout,” the study says.

Researchers also found a connection between lower rates of teamwork on order entry and physician departure which confirms evidence that team-based care can reduce professional burnout and optimize team performance, according to the study.

These results suggest that a model based on EHR data could identify physicians at a high risk of departure which could benefit from targeted, team-based care interventions.

While the researchers note these connections, they also point out that physician characteristics and productivity are likely more strongly associated with physician turnover than EHR use.

“Additional future research could prospectively track physician productivity and EHR use patterns to identify physicians at risk of departure, thereby potentially allowing practice leaders to intervene and retain physicians at the highest risk of departure,” the study says.