Detection, Evaluation, and Best Practices for Technology-Based Fatigue to Promote Well-Being

As telehealth, mobile health, and other technologies reshape the delivery of health care, a thorough evaluation is needed for barriers related to workflow that contribute to provider fatigue and may affect quality of care. The relationship between technology, fatigue, and health care needs to be explored in order to improve conditions for providers. The literature about synchronous video, telephone, informatics systems, asynchronous wearable sensors, and mobile health technologies used in health care suggests substantial behavioral, cognitive, emotional, and physical impact on users. This may vary based on individual, clinic, hospital, and system/organizational workplaces. Video and electronic health record use are associated with fatigue with: physical eye fatigue, neck pain, stress, and tiredness; behavioral impact related to additional effort due to barriers, trouble with engagement, emotional wear and tear, and exhaustion; cognitive inattention, effort, expecting problems, multi-tasking, and workload; and emotional experiences like anger, irritability, stress, and concern about well-being. Other studies not focusing on fatigue also found high user ratings on data quality, accuracy, and processing, but low satisfaction with clerical tasks, the effort required in work, and interruptions costing time and resulting in more errors, stress, and frustration. Few studies discuss the physical environment, occupational health approaches, mobile, telework, Lean, human factor, and user design approaches to workflow. Clinicians and health care systems need to evaluate the impact of technology and consider implementation approaches, process improvement, and human factors to promote well-being and reduce fatigue.