Electronic Health Records and the COVID-19 Pandemic

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Sequeira et al. (2021) acknowledged that the year 2020 saw rapid change in the healthcare system. For example, in mid-May 2020, nearly five million people contracted Covid-19 worldwide, already causing tens of thousands of deaths (Dong et al., 2020). With the spread of Covid-19, nations dealt with massive casualties, as hospitals continued to witness an increased number of infected persons across the world. For instance, Esmaeilzadeh & Mirzaei (2021) believed that the Covid-19 pandemic emerged as the most significant health challenge that clinicians must tackle across the world. In August 2021, roughly 232 million people have Covid, with around 4.7 million deaths linked to the same (Esmaeilzadeh & Mirzaei, 2021). The proliferated number of Covid-19 infected persons globally exposed clinicians to new work conditions characterized by increased workload and increased dangers of being infected.

The problem of clinician burnout during the Covid-19 pandemic becomes one of the key issues of concern, as clinicians forcefully spend more hours attending to the large pool of infected persons flocking healthcare centers in search of treatment (Ferry et al., 2020). However, the emergence of electronic health records (EHRs) has, in a vast way, served a crucial role in helping clinicians to avoid burnout, given that the EHR offers clinicians several features to attain a health systems clinical needs (Kisa, 2020). Therefore, this paper aims to evaluate how EHR features impact the burnout of clinicians working in hospitals that patients admitted with covid-19 infections.

The outbreak of Covid-19 exposed healthcare professionals to patients with severe as well as mild symptoms. Although, for this reason, respiratory droplets and close contact are the main portals of entry that Covid-19 spreads, medical personnel are increasingly vulnerable to Covid-19 infections given that they directly attend to the Covid-19 patients (Ferry et al., 2020). These avenues result in health-linked stress amongst clinicians. Furthermore, the health professionals are not resilient to the stresses due to augmented phone calls from Covid-19 patients, patient portal messages, and numerous walk-in-patients on top of ambulatory care visits (Buran & Alt1n, 2021). Also, the number of Covid-19 patients seeking healthcare services generated additional workload to individuals, thus resulting in adverse burnout levels.

However, the use of EHR during this Covid-19 pandemic improved clinicians ability to establish diverse strategies to boost their capacity to manage the pandemic. Carayon et al. (2020) emphasized that the EHR contains several features that allow medical professionals to use several standardized processes, including scripted triaging, real-time data analytics, telemedicine, electronic check-in, self-screening pages, and timely health information exchange. Furthermore, the ability of EHRs to enable individuals to have access to various safe techniques caring for the Covid-19 patients, including electronic check-in and self-screening pages, reduced clinician burnout (Esmaeilzadeh & Mirzaei, 2021). In addition, through electronic check-in and self-screening pages, medical personnel must overcome some key factors such as the manual registration and recording of visiting patients, thus lowering the workload to clinicians and other healthcare professionals (Faisal et al., 2021). On the contrary, the fact remains that in a healthcare facility, medical professionals are not trainable to leverage health information technologies in their daily activities. At the same time, the introduction of EHRs is cumbersome to untrained clinicians.

As it stands, EHR use is compounded by other significant issues such as clinical volumes as well as the clinicians flexibility to overcome unplanned challenges. Likewise, Jalili et al. (2020) argue that the role of EHR in lowering clinician burnout, innovative techniques to lessen burnout at this present era of Covid-19 is devisable. Even so, Ferry et al (2020) show that EHR innovations cannot help reduce the level of clinicians burnout if healthcare centers fail to take planned calculations towards understating the socio-ecological context, national policy, and organizational culture under which these technologies occur.

The study on the effects of EHRs on clinicians burnout in Iran shows that medical professionals who had proper training on how to use EHRs in managing Covid-19 patients reported accelerated EHR usability. Training is one of the critical factors to enhance their ability to deliver healthcare services to Covid-19 patients, thus, in the long-term, lessening their burnout levels (Madhavan et al., 2020). Moreover, individuals trained on the use of EHRs reported that they found EHRs as a valuable tool to support Covid-19 outbreak management (Kisa, 2020). They argued that their hospitals shared higher standards for data entry and exchanging health information with other hospitals.

Nevertheless, over 168 clinicians surveyed during the study reported having no training on the use of EHRs. As a result, they acknowledged facing enormous challenges when filling data of these electronic records (Kisa, 2020). These challenges added a burden to untrained users, thus leading to more burnout. This finding aligns with the previous studies showing that poor EHR usability results in clinicians dissatisfaction. From the above literature and survey, it is apparent that trained health professionals find EHRs easier to leverage to lessen their burden, a move that results in lower burnout levels (Madhavan et al., 2020). For instance, hospitals that properly train staff tend to have well-integrated EHR systems and retain close collaboration with other hospitals, thus promoting their clinicians ability to have timely access to the patients data during this stressful Covid-19 period. In the long run, the staff can balance EHRs as an effective tool to support Covid-19 outbreak management (Sequeira et al., 2021). Studies show that the more training clinicians obtain on EHRs, the less likely they experience burnout while monitoring the Covid-19 pandemic. On the other hand, untrained staff finds it strenuous to use EHRs in managing the Covid-19 pandemic, a move that resulted in higher levels of burnout.

The current pandemic may be considered to be one of the most significant disasters that occurred during the last several decades. Not only it caused considerable social, economic, and even political damage, but it also reshaped the ways of life worldwide. In some cases, the adverse effects of COVID-19 and restrictions related to the pandemic were deteriorated by a lack of relevant disaster management knowledge and experience. As a consequence, most industries faced unprecedented problems, and without appropriate response frameworks, in many cases, they failed to provide an adequate, timely solution. Nonetheless, the healthcare industry was under the most severe pressure of emerging problems, ethical dilemmas, and uncertainty. Consequently, healthcare underwent the most noticeable changes and implemented a wide variety of relevant measures, which were proven to be effective during the early stages of the pandemic. Digital technologies were broadly implemented as a response to quarantine-related limitations, and the healthcare system was no exception. Some sources state that even though emerging EHRs may face a number of limitations, the mechanism is highly promising and scalable (Brat et al., 2020). Therefore it developed rapidly and was implemented into practice in order to address various problems, including medical worker burnout.

There are several dimensions in which the implementation of EHRs may be beneficial for the healthcare system. As already mentioned, one of these dimensions is reducing medical worker burnout. It may not only achieve that goal during the current pandemic but also provide practical frameworks for the further continuing operation of medical facilities. The second dimension is the possibility to reduce direct contacts between clinicians, which corresponds with the current covid-related restrictions. Another possible benefit of EHRs is the opportunity to analyze big data effectively in accordance with the principles of patient-centered care. Recent research suggests that it may enhance individual risk profiling and consequently improve patient outcomes (Faisal et al., 2021). A number of potential benefits combined with the necessity to provide a response to the emerging post-covid paradigm make EHR a promising initiative. Nevertheless, there are several limitations and barriers that may prevent successful implementation. One of the most significant barriers is insufficient experience of using EHRs among medical workers. Lack of knowledge needed to operate EHRs may considerably reduce the potential benefits.

Based on the above findings, it is obvious that hospitals need to ensure that EHRs serve a viable role in reducing clinician burnout during this Covid-19 pandemic; they must improve the EHR user-friendliness and convenience (Buran & Alt1n, 2021). The reduction in burnout is obtainable by adequately training staff. In addition, it promotes users ability to leverage EHRs to access Covid-19 patients data (Buran & Alt1n, 2021). Having access to their Covid-19 patients data, health professionals do not undertake the process of collecting patients data from the beginning (Esmaeilzadeh & Mirzaei, 2021). Therefore, introducing comprehensive training frameworks should become the first priority for EHR implementation programs.

Conclusively, a significant correlation was determined between the use of EHRs and lesser burnout of medical employees who work with covid-19 cases. Several sources supported the presumption that EHR may considerably decrease covid-related workload and stress (Esmaeilzadeh & Mirzaei, 2021). However, further research may be needed in order to identify which aspects of EHRs have the most noticeable impact on worker burnout reduction. Moreover, it may be beneficial to widen the research by considering worker burnout unrelated to covid-19. Such scientific data may be utilized in order to improve EHRs implementation frameworks and provide appropriate training programs.

References

Brat, G. A., Weber, G. M., Gehlenborg, N., Avillach, P., Palmer, N. P., Chiovato, L., Cimino, J., Waitman, L. R., Omenn, G. S., Malovini, A., Moore, J. H., Beaulieu-Jones, B. K., Tibollo, V., Murphy, S. N., Yi, S. L., Keller, M. S., Bellazzi, R., Hanauer, D. A., Serret-Larmande, A., & Kohane, I. S. (2020). International electronic health RECORD-DERIVED COVID-19 clinical course profiles: THE 4CE consortium. Npj Digital Medicine, 3(1).

Buran, F., & Alt1n, Z. (2021). Burnout among physicians working in a pandemic hospital during the COVID-19 pandemic.Legal Medicine, 51, 101881.

Carayon, P., Cassel, C., & Dzau, V. J. (2020). Clinician burnout and professional well-beingReply. JAMA, 323(13), 1318.

Dong, E., Du, H., & Gardner, L. (2020). An interactive web-based dashboard to track Covid-19 in real time. The Lancet, 20(5), 533-538.

Esmaeilzadeh, P., & Mirzaei, T. (2021). Using electronic health records to mitigate workplace burnout among clinicians during the COVID-19 pandemic: Field study in Iran (Preprint). Web.

Faisal, A., Lannou, E. L., Post, B., Haar, S., Brett, S., & Kadirvelu, B. (2021). Clustering of patient comorbidities within electronic medical records enables high-precision COVID-19 mortality prediction. Web.

Ferry, A. V., Wereski, R., Strachan, F. E., & Mills, N. L. (2020). Predictors of healthcare worker burnout during the COVID-19 pandemic. Web.

Jalili, M., Niroomand, M., Hadavand, F., Zeinali, K., & Fotouhi, A. (2020). Burnout among healthcare professionals during COVID-19 pandemic: A cross-sectional study. Web.

Kisa, S. (2020). Burnout among physicians and nurses during COVID-19 pandemic. European Journal of Environment and Public Health, 4(2), em0055. Web.

Madhavan, S., Bastarache, L., Brown, J. S., Butte, A. J., Dorr, D. A., Embi, P. J., Friedman, C. P., Johnson, K. B., Moore, J. H., Kohane, I. S., Payne, P. R., Tenenbaum, J. D., Weiner, M. G., Wilcox, A. B., & Ohno-Machado, L. (2020). Use of electronic health records to support a public health response to the COVID-19 pandemic in the United States: A perspective from 15 academic medical centers.Journal of the American Medical Informatics Association, 28(2), 393-401.

Sequeira, L., Almilaji, K., Strudwick, G., Jankowicz, D., & Tajirian, T. (2021). EHR SWAT teams: A physician engagement initiative to improve electronic health record (EHR) experiences and mitigate possible causes of EHR-related burnout. JAMIA Open, 4(2).

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Electronic Health Records and the COVID-19 Pandemic

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