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Appl Clin Inform 2025; 16(03): 662-675
DOI: 10.1055/a-2562-0910
Research Article

Development of the TrendBurden Survey: Assessing Perceived Documentation Burden among Health Professionals in the United States

Elizabeth A. Sloss   *
1   College of Nursing, University of Utah, Salt Lake City, Utah, United States
,
Ayomide Owoyemi   *
2   Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, Illinois, United States
,
Anup Kumar Mishra
3   Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Kathleen Sidwell
4   American Medical Informatics Association, Washington, District of Columbia, United States
,
Shanawaz Abdul
5   John Dingell VA Medical Center, Detroit, Michigan, United States
,
Gigi Dawood
6   UW- Madison University Hospital and Clinics, Madison, Wisconsin, United States
,
Matthew R. Allen
7   University of California San Diego, School of Medicine, La Jolla, California, United States
,
Davis Austria
8   VA Quality Scholars Fellowship, Health Equity & Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Veterans Affairs (VA) Health Care System, Charleston, South Carolina, United States
,
Zachary Pope
9   UC Davis Health, Sacramento, California, United States
,
Faraaz Chekeni
10   Nationwide Children's Hospital, Columbus, Ohio, United States
11   College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Sarah Corley
12   MITRE Corporation, McLean, Virginia, United States
,
Aaron Grigg
13   Grande Ronde Hospital and Clinics, La Grande, Oregon, United States
,
Vince Hartman
14   Abstractive Health, New York, New York, United States
,
Kevin B. Johnson
15   Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
16   Applied Informatics, University of Pennsylvania Health System, Philadelphia, Pennsylvania, United States
,
Deborah R. Levy
17   Department of Veterans Affairs, Amarillo VA Healthcare System, Amarillo, Texas, United States
18   Department of Biomedical Informatics and Data Sciences, Yale University School of Medicine, New Haven, Connecticut, United States
,
Kyle Marshall
19   Geisinger Commonwealth School of Medicine Clinical Informatics, Scranton, Pennsylvania, United States
,
Judy Murphy
20   Independent, Minneapolis, Minnesota, United States
,
Barry Newman
21   Providence Health, Portland, Oregon, United States
,
Toni Phillips
22   U.S. Department of Veterans Affairs, Gainesville, Florida, United States
,
Kevin D. Smith
23   University of Chicago Medicine, Chicago, Illinois, United States
,
James Szymanski
24   Montefiore Medical Center/Albert Einstein School of Medicine, Bronx, New York, United States
,
Sarah Rossetti
25   Department of Biomedical Informatics, Columbia University Medical Center, New York, New York
› Author Affiliations
Funding None.
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Abstract

Background

Documentation burden contributes to health professional burnout and negatively impacts health professional well-being and patient care quality. Yet, there is a gap in the literature regarding an effective measure to assess the perceived documentation burden of health professionals in a wide range of care settings over time.

Objectives

We developed and administered a pulse survey to trend, with subsequent administrations, the perceived documentation burden of health professionals in all care settings in the United States over time.

Methods

A multimethods approach was used which included conducting a scoping review of the literature to identify and then curate a set of potential survey items based on scoping review results. Next, a modified Delphi approach was used with clinical informatics experts for consensus-driven item selection and pulse survey development. Finally, we administered the pulse survey nationally using snowball sampling through professional listservs and networks of organizations.

Results

The scoping review helped to identify constructs and items to include on the pulse survey. After four iterations of the modified Delphi approach, consensus was reached on five final items for the pulse survey, labeled “TrendBurden.” The first administration of “TrendBurden” was completed by 1,253 healthcare professionals in April 2024. Most respondents (73.26%) disagreed that the time and effort spent documenting patient care is appropriate, with 77.42% reporting finishing work later or needing to work from home due to excessive documentation tasks. Seventy-four point three-eight percent agreed that the effort or time required to complete documentation tasks impedes patient care, and less than one-third (31.76%) agreed that the EHR is easy to use.

Conclusion

The “TrendBurden” Pulse Survey was developed through a scoping review of the literature and expert consensus. The resulting five-question pulse survey was administered nationally and provided insight into current perceptions of documentation burden among healthcare professionals.

Keywords

excessive documentation burden - pulse survey - electronic health record

Protection of Human and Animal Subjects

Protection of Human and Animal Subjects was approved by the Columbia University IRB-AAAT4200.


* Co-Primary Authors.




Publication History

Received: 09 August 2024

Accepted: 18 March 2025

Article published online:
16 July 2025

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