​Frintner MP, Kaelber D, Kirkendall E, Lehmann C, Lourie E

Accepted for 2020 Pediatric Academic Societies Annual Meeting

Background: Use of electronic health records (EHRs) has become standard with 94% of physicians in pediatric offices using EHRs in 2016.[i] At the same time there is growing awareness of administrative burdens related to EHRs. Work-life balance is a priority among young physicians. Little is known about how EHR experiences relate to work-life balance and satisfaction.

Objective: Examine the association of EHR burden with work-life balance and satisfaction.

Methods: We analyzed 2018 national cross-sectional survey data from the AAP Pediatrician Life and Career Experience Study (PLACES), a longitudinal study of 2 cohorts of early to midcareer pediatricians (2002-04 and 2009-11 residency graduates). 1249 of 1798 pediatricians (69%) completed the 2018 survey (analytic sample=1117). Chi-square tests examined associations of pediatrician reported EHR burden (major/moderate vs minor/no burden) with work-life balance (3 measures) and satisfaction (3 measures). Multivariable logistic regression examined the independent effect of EHR burden for the 6 measures, controlling for cohort, gender, medical school location, marriage, children, part-time hours, specialty (primary care, hospitalist, subspecialist), practice ownership and level of input on EHR procedures and staffing.

Results74% of pediatricians reported EHR documentation was a major or moderate burden. 73% reported they have no or minor input in decisions regarding EHR procedures and staffing. While most were satisfied with their jobs (87%), careers (84%), and lives (67%), many struggled with work-life balance (eg, 54% reported stress balancing work and personal responsibilities).

Pediatricians reporting burden from EHR documentation were less likely to report satisfaction with career and life and with time for personal interests (Figure 1). They were also more likely to bring work home on a daily basis and to report stress in work-life balance. In multivariable analysis, all bivariate effects for EHR burden in figure 1 remained significant.

Conclusions: Most early to midcareer pediatricians experience administrative burdens with EHRs. These experiences are associated with worse work-life balance including more stress in balancing responsibilities and less career and life satisfaction. Strategies to decrease the burdens experienced with EHRs are needed. 


AAP PLACES 2002-04 and 2009-11 Residency Graduates Cohort

*p<.05 for Chi-square test that examined EHR burden (major/moderate vs minor/no burden) and work-life balance and satisfaction measures.

[i]Temple MW, Sisk B, Krams LA, Schneider JH, Kirkendall ES, Lehmann CU. Trends in Use of Electronic Health Records in Pediatric Office Settings. J Pediatr. 2019
Mar;206:164-171.e2. doi: 10.1016/j.jpeds.2018.10.039. Epub 2018 Dec 5. PubMed PMID: 30527749.