Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Predictors of physicians’ stress related to information systems: a nine-year follow-up survey study

Authors: Tarja Heponiemi, Hannele Hyppönen, Sari Kujala, Anna-Mari Aalto, Tuulikki Vehko, Jukka Vänskä, Marko Elovainio

Published in: BMC Health Services Research | Issue 1/2018

Login to get access

Abstract

Background

Among the important stress factors for physicians nowadays are poorly functioning, time consuming and inadequate information systems. The present study examined the predictors of physicians’ stress related to information systems (SRIS) among Finnish physicians. The examined predictors were cognitive workload, staffing problems, time pressure, problems in teamwork and job satisfaction, adjusted for baseline levels of SRIS, age, gender and employment sector.

Methods

The study has a follow-up design with two survey data collection waves, one in 2006 and one in 2015, based on a random sample of Finnish physicians was used. The present study used a sample that included 1109 physicians (61.9% women; mean age in 2015 was 54.5; range 34–72) who provided data on the SRIS in both waves. The effects of a) predictor variable levels in 2006 on SRIS in 2015 and b) the change in the predictor variables from 2006 to 2015 on SRIS in 2015 were analysed with linear regression analyses.

Results

Regression analyses showed that the higher level of cognitive workload in 2006 significantly predicted higher level of SRIS in 2015 (β = 0.08). The reciprocity of this association was tested with cross-lagged structural equation model analyses which showed that the direction of the association was from cognitive workload to SRIS, not from SRIS to cognitive workload. Moreover, increases in time pressure (β = 0.16) and problems in teamwork (β = 0.10) were associated with higher levels of SRIS in 2015, whereas job satisfaction increase was associated with lower SRIS (β = − 0.06).

Conclusions

According to our results, physicians’ cognitive workload may have long-lasting negative ramifications in regard to how stressful physicians experience their health information systems to be. Thus, organisations should pay attention to physicians workload if they wish physicians to master all the systems they need to use. It is also important to provide physicians with enough time and collegial support in their system-related problems, and in learning new systems and system updates.
Literature
1.
Vänskä J, Viitanen J, Hyppönen H, Elovainio M, Winblad I, Reponen J, Lääveri T. Lääkärien arviot potilastietojärjestelmistä kriittisiä [Doctors critical of electronic patient record systems]. Finn Med J. 2010;50-52:4177–83.
2.
Heponiemi T, Hyppönen H, Vehko T, Kujala S, Aalto AM, Vänska J, Elovainio M. Finnish physicians' stress related to information systems keeps increasing: a longitudinal three-wave survey study. BMC Med Inform Decis Mak. 2017;17(1):147.CrossRefPubMedPubMedCentral
3.
Shanafelt TD, Dyrbye LN, Sinsky C, Hasan O, Satele D, Sloan J, West CP. Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clin Proc. 2016;91(7):836–48.CrossRefPubMed
4.
Viitanen J, Hyppönen H, Lääveri T, Vänska J, Reponen J, Winblad I. National questionnaire study on clinical ICT systems proofs: physicians suffer from poor usability. Int J Med Inform. 2011;80(10):708–25.CrossRefPubMed
5.
Kaipio J, Lääveri T, Hyppönen H, Vainiomäki S, Reponen J, Kushniruk A, Borycki E, Vänska J. Usability problems do not heal by themselves: national survey on physicians' experiences with EHRs in Finland. Int J Med Inform. 2017;97:266–81.CrossRefPubMed
6.
Beasley JW, Wetterneck TB, Temte J, Lapin JA, Smith P, Rivera-Rodriguez AJ, Karsh BT. Information chaos in primary care: implications for physician performance and patient safety. J Am Board Fam Med. 2011;24(6):745–51.CrossRefPubMedPubMedCentral
7.
Vänskä J, Vainiomäki S, Kaipio J, Hyppönen H, Reponen J, Lääveri T. Potilastietojärjestelmät lääkärin työvälineenä 2014: käyttäjäkokemuksissa ei merkittäviä muutoksia. Suom Lääkäril. 2014;49:3351–8.
8.
Edwards PJ, Moloney KP, Jacko JA, Sainfort F. Evaluating usability of a commercial electronic health record: a case study. Int J Hum Comp Stud. 2008;66:718–28.CrossRef
9.
Winblad I, Hyppönen H, Vänskä J, Reponen J, Viitanen J, Elovainio M, Lääveri T. Potilastietojärjestelmät tuotemerkittäin arvioitu: Kaikissa on kehitettävää [electronic patient record systems evaluated by make of product: further development required in all cases]. Finn Med J. 2010;50-52:4185–94.
10.
Babbott S, Manwell LB, Brown R, Montague E, Williams E, Schwartz M, Hess E, Linzer M. Electronic medical records and physician stress in primary care: results from the MEMO study. J Am Med Inform Assoc. 2014;21(e1):e100–6.CrossRefPubMed
11.
Friedberg M, Chen P, Van Busum R, Aunon F, Pham C, Caloyeras J, Mattke S, Pitchforth E, Quigley DD, Brook RH: Factors affecting physician professional satisfaction and their implications for patient care. Washington, DC: Rand offices; 2013.
12.
O'Malley AS, Cohen GR, Grossman JM. Electronic medical records and communication with patients and other clinicians: are we talking less? Issue Brief Cent Stud Health Syst Change. 2010;131:1–4.
13.
Street RL Jr, Liu L, Farber NJ, Chen Y, Calvitti A, Zuest D, Gabuzda MT, Bell K, Gray B, Rick S, et al. Provider interaction with the electronic health record: the effects on patient-centered communication in medical encounters. Patient Educ Couns. 2014;96(3):315–9.CrossRefPubMedPubMedCentral
14.
Shachak A, Hadas-Dayagi M, Ziv A, Reis S. Primary care physicians' use of an electronic medical record system: a cognitive task analysis. J Gen Intern Med. 2009;24(3):341–8.CrossRefPubMedPubMedCentral
15.
Vänskä J, Vainiomäki S, Kaipio J, Hyppönen H, Reponen J, Lääveri T. Potilastietojärjestelmät lääkärin työvälineenä 2014: käyttäjäkokemuksissa ei merkittäviä muutoksia. [electronic patient record systems as physicians’ tools in 2014: no significant changes in user experience reported by physicians]. Finnish Med J. 2014;69:3351–8.
16.
Simon SR, Kaushal R, Cleary PD, Jenter CA, Volk LA, Orav EJ, Burdick E, Poon EG, Bates DW. Physicians and electronic health records: a statewide survey. Arch Intern Med. 2007;167(5):507–12.CrossRefPubMed
17.
18.
Smith PC, Araya-Guerra R, Bublitz C, Parnes B, Dickinson LM, Van Vorst R, Westfall JM, Pace WD. Missing clinical information during primary care visits. JAMA. 2005;293(5):565–71.CrossRefPubMed
19.
Kirsh D. A few thoughts on cognitive overload. Intellectica. 2000;30:19–51.
20.
Firth-Cozens J, Morrison L. Sources of stress and ways of coping in junior house officers. Stress Med. 1989;5:121–6.CrossRef
21.
Karasek R. Demand-control model: a social, emotional, and physiological approach to stress risk and active behaviour development. In: In encyclopedia of occupational health and safety. Geneva: international labour Office; 1998.
22.
Inglesias MEL, Vallejo RBB. Prevalence and relationship between burnout, job satisfaction, stress, and clinical manifestations in Spanish critical care nurses. Dimens Critic Care Nurs. 2013;32:130–7.CrossRef
23.
Law FM, Guo GJ. Correlation of hope and self-efficacy with job satisfaction, job stress, and organizational commitment for correctional officers in the Taiwan prison system. Int J Offender Ther Comp Criminol. 2015;60(11):1257–77.CrossRefPubMed
24.
Hyppönen H, Hämäläinen P, Reponen J. e-health and e-welfare of Finland: check point 2015. National Institute for health and welfare (THL) report 18/2015. Tampere: Juvenes Print Oy; 2015.
25.
Elovainio M, Heponiemi T, Vänskä J, Sinervo T, Kujala S, Laakso E, Jalonen P, Hakanen J, Husman K, Töyry S, et al. [how well are Finnish physicians in the 21st century?] Kuinka suomalainen lääkäri Voi 2000-luvulla? Finn Med J. 2007;20–21:2071–6.
26.
Heponiemi T, Aalto AM, Pekkarinen L, Siuvatti E, Elovainio M. Are there high-risk groups among physicians that are more vulnerable to on-call work? Am J Emerg Med. 33(5):614–9.
27.
Kuusio H, Heponiemi T, Aalto AM, Sinervo T, Elovainio M. Differences in well-being between GPs, medical specialists, and private physicians: the role of psychosocial factors. Health Serv Res. 2012;47(1 Pt 1):68–85.CrossRefPubMed
28.
Elovainio M, Kivimäki M. Work and strain on physicians in Finland. Scand J Soc Med. 1998;26(1):26–33.CrossRefPubMed
29.
Hackman JR, Oldham GR. Development of the job diagnostic survey. J Appl Psychol. 1975;60(2):159–70.CrossRef
30.
Byrne BM. Structural equation modeling with LISREL, PRELIS, and SIMPLIS: basic concepts, applications, and programming. Mahwah, NJ: Erlbaum; 1998.
31.
Day A, Paquet S, Scott N, Hambley L. Perceived information and communication technology (ICT) demands on employee outcomes: the moderating effect of organizational ICT support. J Occup Health Psychol. 2012;17(4):473–91.CrossRefPubMed
32.
Hancock PA, Szalma JL. Operator stress and display design. Ergon Des. 2003;11:13–8.
33.
Howard J, Clark EC, Friedman A, Crosson JC, Pellerano M, Crabtree BF, Karsh BT, Jaen CR, Bell DS, Cohen DJ. Electronic health record impact on work burden in small, unaffiliated, community-based primary care practices. J Gen Intern Med. 28(1):107–13.
34.
Boonstra A, Broekhuis M. Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions. BMC Health Serv Res. 2010;10:231.CrossRefPubMedPubMedCentral
35.
Cheriff AD, Kapur AG, Qiu M, Cole CL. Physician productivity and the ambulatory EHR in a large academic multi-specialty physician group. Int J Med Inform. 2010;79(7):492–500.CrossRefPubMed
36.
Adler-Milstein J, Huckman RS. The impact of electronic health record use on physician productivity. Am J Manag Care. 2013;19(10 Spec):SP345–52.PubMed
37.
Castillo VH, Martinez-Garcia AI, Pulido JR. A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review. BMC Med Inform Decis Mak. 2010;10:60.CrossRefPubMedPubMedCentral
38.
Jones CD, Holmes GM, Lewis SE, Thompson KW, Cykert S, DeWalt DA. Satisfaction with electronic health records is associated with job satisfaction among primary care physicians. Inform Prim Care. 2013;21(1):18–20.CrossRefPubMed
39.
Dastagir MT, Chin HL, McNamara M, Poteraj K, Battaglini S, Alstot L. Advanced proficiency EHR training: effect on physicians' EHR efficiency. EHR satisfaction and job satisfaction AMIA Annu Symp Proc. 2012;2012:136–43.PubMed
40.
Ahmed A, Chandra S, Herasevich V, Gajic O, Pickering BW. The effect of two different electronic health record user interfaces on intensive care provider task load, errors of cognition, and performance. Crit Care Med. 2011;39(7):1626–34.CrossRefPubMed
41.
Contratto E, Romp K, Estrada CA, Agne A, Willett LL. Physician order entry clerical support improves physician satisfaction and productivity. South Med J. 2017;110(5):363–8.PubMed
42.
O'Malley AS, Grossman JM, Cohen GR, Kemper NM, Pham HH. Are electronic medical records helpful for care coordination? Experiences of physician practices. J Gen Intern Med. 2009;25(3):177–85.CrossRefPubMedPubMedCentral
43.
Shaha JS, El-Othmani MM, Saleh JK, Bozic KJ, Wright J, Tokish JM, Shaha SH, Saleh KJ. The growing gap in electronic medical record satisfaction between clinicians and information technology professionals: issues of most concern and suggested Remediations. J Bone Joint Surg Am. 2015;97(23):1979–84.CrossRefPubMed
44.
Martikainen S, Viitanen J, Korpela M, Lääveri T. Physicians' experiences of participation in healthcare IT development in Finland: willing but not able. Int J Med Inform. 2012;81(2):98–113.CrossRefPubMed
45.
Guo U, Chen L, Mehta PH. Electronic health record innovations: helping physicians - one less click at a time. HIM J. 2017;46(3):140–4.CrossRef
Metadata
Title
Predictors of physicians’ stress related to information systems: a nine-year follow-up survey study
Authors
Tarja Heponiemi
Hannele Hyppönen
Sari Kujala
Anna-Mari Aalto
Tuulikki Vehko
Jukka Vänskä
Marko Elovainio
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3094-x

Other articles of this Issue 1/2018

BMC Health Services Research 1/2018 Go to the issue

Research article

What value for whom? – provider perspectives on health examinations for asylum seekers in Stockholm, Sweden

Research article

Experiences of primary care physicians and staff following lean workflow redesign

Research article

Private retail drug shops: what they are, how they operate, and implications for health care delivery in rural Uganda

Research article

Conventional and complementary cancer treatments: where do conventional and complementary providers seek information about these modalities?

Research article

Evidence to service gap: cardiac rehabilitation and secondary prevention in rural and remote Western Australia

Research article

Accuracy and the factors influencing the accuracy of death certificates completed by first-year general practitioners in Thailand