​Although some primary care physicians were enthusiastic about the ability of an electronic consult (eConsult) system to increase access to specialty care providers, others were concerned that the system adds to their own workload, according to a study published in the June 2018 issue of JAMA Internal Medicine. Researchers included 40 primary care physicians in a study on the association between eConsult systems and the perceptions of frontline primary care physicians in safety-net health systems. One primary care physician included in the study said, "Prior to eConsult we were writing all our referrals on paper and there was little to no communication . . . we were pretty much in the dark." Another primary care physician explained that eConsult systems could give patients appointments to specialty care providers sooner, reducing the need to send them to the emergency department for treatment. But other responses from primary care physicians showed concern about shifting the work burden to primary care. One physician responded that the system is "wasting multiple primary care visits to accomplish what [the specialist] could in 1 session." According to a related editorial also published in the June 2018 issue of the journal, the concerned responses from primary care physicians are likely linked to the well-known issue of burnout. Technological interventions and burnout are often closely linked, according to the editorial, and adding to the "desktop burden" of a physician is likely to increase that burnout. Perhaps the study should be seen not as a final answer on whether eConsult systems are a viable solution to increasing access to specialty care providers, but instead should be seen as a continuing discussion on how best to implement the system, the author says. The June 2018 issue of JAMAInternal Medicine includes another study on physician burnout, titled, "Correlates and Outcomes of Physician Burnout within a Large Academic Medical Center." The June 2018 issue of JAMA Internal Medicine includes a research letter on physician burnout, which found that 35% of 1,145 physicians responding to a survey met criteria for burnout.  

HRC Recommends: Changes in the healthcare industry have increasingly led physicians—and other clinical providers—to feel as though they have lost control over their professional roles. Over time, this loss of control, the threat of lawsuits, and disconnection from other providers and members of the healthcare team can result in burnout. Technological tasks are among the factors that can contribute to burnout. Therefore, it is important to monitor for unintended consequences when implementing new technologies, attempting to address or mitigate them when possible. To that end, organizations may establish balancing measures to track whether initiatives are unintentionally causing problems.