Physicians’ use of EHR on vacations may hurt their ability to ‘disconnect from work’

Key takeaways:

• Physicians logged over a median 16 minutes of EHR time a day during paid time off days.
• Physicians also spent a median 50% of days during shorter vacation blocks with some EHR time.

Physicians often engage in electronic health record activities during their paid time off, according to a research letter published in JAMA Network Open.

Results from the cohort analysis showed that most of this work came near the beginning and end of vacations.

“We felt the results were intuitive,” Corey S. Obermiller, MStat, a biostatistician at Atrium Health Wake Forest Baptist, told Healio. “While the actual amount of time spent in the EHR was not astoundingly high, we believe that even small amounts of EHR engagement could disrupt a physician’s ability to mentally disconnect from work.”

The results come after previous research indicated that working 30 minutes or more daily during vacation corresponded with higher rates of burnout among physicians.

In the current retrospective analysis, Obermiller and colleagues examined EHR use among 56 primary care providers during their vacation blocks, defined as 2 consecutive paid time off (PTO) days “including their adjacent or inclusive weekends.”

The researchers classified vacation blocks as short (2 to 5 days), medium (6 to 10 days) or long (over 10 days).

They found a median EHR time per PTO day of 16.1 minutes, with a median of 39% of days having at least some EHR use and 19% of days having over 30 minutes per day.

Obermiller told Healio that one finding that stood out to him and his colleagues was that physicians spent a median of 50% of vacation days during shorter blocks with some EHR use.

Meanwhile, 18% of days in longer vacation blocks included some EHR time.

The researchers also pointed out that physicians spent a median of 57% of first vacation days in the EHR and bookended that with 63.5% of last days of vacation.

In contrast, physicians spent only a median of 29% of days in the middle of vacation in the EHR.

Obermiller and colleagues noted that the physicians spent a median 39.5% of total EHR time performing inbox-related tasks.

The researchers identified several study limitations. For example, PTO data were only available for academic physicians, while the researchers noted that including weekends at both ends of PTO blocks “may have overestimated their length, although sensitivity analyses showed no significant association.”

There is no universal solution to the challenges of separating work and PTO, “but institutions should implement and evaluate support systems that empower physicians to have autonomy in deciding whether to engage in work tasks while away,” Obermiller told Healio.

He explained that future research should focus on interventions aimed at improving coverage systems for physicians on vacation.

“We fully understand that physicians each have different perspectives on EHR use and how to spend their time away from work,” he added. “Some people feel better checking in briefly, while others may prefer complete disconnection from work.”

“Ideally, regardless of personal thoughts and habits, all PCPs should feel confident that they can fully step away from their work responsibilities without worrying about administrative or other work-related tasks piling up in their absence.”

For more information:

Corey S. Obermiller, MStat, can be reached at cobermil@wakehealth.edu.