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ABSTRACT
Objectives: Electronic health record (EHR) inbox notifications can be burdensome for primary care providers (PCPs), potentially contributing to burnout. We estimated the association between changes in the quantities of EHR inbox notifications and PCP burnout.
Study Design: In this observational study, we tested the association between the percent change in daily inbox notification volumes and PCP burnout after an initiative to reduce low-value notifications at the Veterans Health Administration (VHA).
Methods: The VHA initiative resulted in increases and decreases in notification volumes for PCPs. For each facility, the proportion of PCPs reporting burnout was estimated using VHA All Employee Survey responses before and after the initiative in 2016 and 2018, respectively. Survey responses were aggregated for 6459 PCPs (physicians, nurse practitioners, and physician assistants) at 138 VHA facilities. Fixed effects regression models estimated the association of small and large increases and small and large decreases in notifications on burnout.
Results: Daily inbox notifications per PCP decreased by a mean (SD) of 5.9% (30.1%) across study facilities, from a mean (SD) of 128 (52) notifications to 114 (44) notifications after the initiative. Fifty-one percent of facilities experienced reductions in notifications, 30% experienced no change, and 20% experienced increased notifications. PCP burnout was not significantly associated with any level of increase or decrease in notifications.
Conclusions: Changes in notification volumes alone did not predict PCP burnout. Future research to reduce burnout might still address EHR notification volumes, but as part of a broader set of strategies that consider the other stressors that PCPs experience.
Am J Manag Care. 2023;29(1):In Press
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Takeaway Points
Automated notifications in the electronic health record (EHR) are a pervasive source of digital workload and fatigue for primary care providers (PCPs). We tested whether provider burnout changed after an initiative was implemented at the Veterans Health Administration to optimize electronic inbox notification volumes.
* We did not find any association between increases or decreases in notification volumes and burnout.
* Reducing notifications alone is likely insufficient to improve burnout.
* Future research should consider multiple aspects of EHR inbox design, in addition to volume, when considering the effects of notification burden on PCPs.
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Although electronic health records (EHRs) improve data management and communication within health care, they can be a source...