ArticleJournal of general internal medicine2022
Temporal Associations Between EHR-Derived Workload, Burnout, and Errors: a Prospective Cohort Study.
Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Controlled Trial of Two Ambient Artificial Intelligence Scribe Technologies to Improve Documentation Efficiency and Reduce Physician Burnout
Emergency Medicine Practitioners Overall Well-being Enhancement With Ambient AI Scribes
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Electronic health records-related determinants of healthcare professionals' burnout and mitigation strategies: systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- Measuring Documentation Burden in Healthcare.Journal of general internal medicine · 2024Pooled it
- Effect of digital tools to promote hospital quality and safety on adverse events after discharge.Journal of the American Medical Informatics Association : JAMIA · 2024Trial
- Association Between Electronic Health Record-Based Nursing Workload and Turnover: Retrospective Cohort Study.JMIR nursing · 2026Article
- Article
- Artificial intelligence-generated encounter summaries: early insights from ambulatory clinicians at a large academic health system.JAMIA open · 2025Article
- Association Between Conversational Multitasking and Clinician Work Behaviors at a Large US Health Care System: Cohort Study.Journal of medical Internet research · 2025Observational
- Exploring Task Patterns in EHR Workflows Using Action Sequence Embedding and Graph-Based Analysis.Studies in health technology and informatics · 2025Article
- Electronic health record activity changes around new decision support implementation: monitoring using audit logs and topic modeling.JAMIA open · 2025Article
- A Randomized-Clinical Trial of Two Ambient Artificial Intelligence Scribes: Measuring Documentation Efficiency and Physician Burnout.medRxiv : the preprint server for health sciences · 2025Article
- Association of EHR-Integrated Secure Messaging Use with Clinician Workload and Attention Switching.Journal of general internal medicine · 2025Article
- The Practice: A Leadership-Endorsed Workplace Intervention to Improve Well-being in Healthcare Professionals.Journal of general internal medicine · 2025Article
- Emerging Domains for Measuring Health Care Delivery With Electronic Health Record Metadata.Journal of medical Internet research · 2025Review
- For AI in Primary Care, Start With the Problem.Annals of family medicine · 2025Article
- Unlocking inpatient workload insights with electronic health record event logs.Journal of hospital medicine · 2025Article
- Secure Messaging Use and Wrong-Patient Ordering Errors Among Inpatient Clinicians.JAMA network open · 2024Article
- The Impact of Diagnosis-Specific Plan Templates on Admission Note Writing Time: A Quality Improvement Initiative.Journal of graduate medical education · 2024Article
- Measuring cognitive effort using tabular transformer-based language models of electronic health record-based audit log action sequences.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Assessing the Usability and Feasibility of Digital Assistant Tools for Direct Support Professionals: Participatory Design and Pilot-Testing.JMIR human factors · 2024Article
- Anesthesia Clinical Workload Estimated From Electronic Health Record Documentation vs Billed Relative Value Units.JAMA network open · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundThe temporal progression and workload-related causal contributors to physician burnout are not well-understood.
objectiveTo characterize burnout's time course and evaluate the effect of time-varying workload on burnout and medical errors.
designSix-month longitudinal cohort study with measurements of burnout, workload, and wrong-patient orders every 4 weeks.
participantsSeventy-five intern physicians in internal medicine, pediatrics, and anesthesiology at a large academic medical center. MAIN MEASURES: Burnout was measured using the Professional Fulfillment Index survey. Workload was collected from electronic health record (EHR) audit logs and summarized as follows: total time spent on the EHR, after-hours EHR time, patient load, inbox time, chart review time, note-writing time, and number of orders. Wrong-patient orders were assessed using retract-and-reorder events. KEY
resultsSeventy-five of 104 interns enrolled (72.1%) in the study. A total of 337 surveys and 8,863,318 EHR-based actions were analyzed. Median burnout score across the cohort across all time points was 1.2 (IQR 0.7-1.7). Individual-level burnout was variable (median monthly change 0.3, IQR 0.1-0.6). In multivariable analysis, increased total EHR time (β=0.121 for an increase from 54.5 h per month (25th percentile) to 123.0 h per month (75th percentile), 95%CI=0.016-0.226), increased patient load (β=0.130 for an increase from 4.9 (25th percentile) to 7.1 (75th percentile) patients per day, 95%CI=0.053-0.207), and increased chart review time (β=0.096 for an increase from 0.39 (25th percentile) to 0.59 (75th percentile) hours per patient per day, 95%CI=0.015-0.177) were associated with an increased burnout score. After adjusting for the total number of ordering sessions, burnout was not statistically associated with an increased rate of wrong-patient orders (rate ratio=1.20, 95%CI=0.76-1.89).
conclusionsBurnout and recovery were associated with recent clinical workload for a cohort of physician trainees, highlighting the elastic nature of burnout. Wellness interventions should focus on strategies to mitigate sustained elevations of work responsibilities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.