Electronic health records-related determinants of healthcare professionals' burnout and mitigation strategies: systematic review and meta-analysis

电子健康记录相关因素对医护人员职业倦怠的影响及缓解策略:系统评价和荟萃分析

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Abstract

BACKGROUND: While the adoption of electronic health records (EHRs) has become widespread, it has been accompanied by a concurrent exacerbation of burnout among healthcare professionals. However, existing research has predominantly focused on single professional groups, lacking comprehensive multi-group analysis and the identification of key modifiable mitigation factors. METHODS: Following the PRISMA guidelines, we systematically searched for relevant literature published between 2005 and 2025. A total of 41 studies, encompassing 54,443 healthcare professionals, were included. A meta-analysis was conducted to assess the association between EHR use and occupational burnout, with subgroup analyses performed to examine differences across various professional groups and assessment tools. Sensitivity analysis was conducted to reduce the bias. RESULTS: The use of EHRs was found to significantly associated with an increase the risk of occupational burnout (OR = 2.49, 95% CI: 1.82-3.41), which was also supported after sensitivity analysis (OR = 1.98, 95% CI: 1.40-2.80). The subgroup analysis revealed that the occurrence rate of burnout was highest in studies using other tools (39.3%), followed by those using the MBI-HSS (36.0%) and was lowest in studies employing the mini-Z (31.8%). This association was evident across multiple groups, The highest occurrence rate among physicians was 38.1%, followed by residents (37.5%), and then nurses (27.8%). The primary contributing factors were poor EHR design, excessive time spent on documentation, and heavy administrative burdens. Conversely, mitigations such as system optimization and the provision of medical scribes have been proposed as potentially beneficial approaches for alleviating burnout. CONCLUSION: EHR use is closely linked to occupational burnout across a broad spectrum of healthcare professionals. There is a critical need for targeted system optimization and the development of tailored mitigation strategies to reduce this growing problem.

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