EMR adoption may increase MSK injuries

Widespread adoption of electronic medical records (EMRs) and related digital technologies may significantly increase musculoskeletal (MSK) injuries among doctors and nurses, according to research from Cornell University.

Poor office layouts and improper use of computer devices are expected to cause repetitive strain injuries, concluded Alan Hedge, a professor in the department of design and environmental analysis in Cornell's College of Human Ecology. He published his findings in two recent papers.

In a paper published in the Proceedings of the HFES 56th Annual Meeting, Hedge and colleague Tamara James reported that the majority of female doctors and more than 40% of male doctors reported repetitive strain ailments on at least a weekly basis.

The most commonly reported repetitive strain injuries among the 179 surveyed physicians were neck, shoulder, and upper and lower back pain. Right wrist injuries were reported by about 40% of women and 30% of men. Gender differences in injuries appeared to be due in part to women spending about an hour longer on the computer per day than men, according to the authors.

In a second study performed at the same hospital system and published in Advances in Human Aspects of Healthcare, 90% of respondents reported using a desktop computer at work and spent more than five hours per day, on average, using computers, according to the researchers.

In addition, the authors found that 56% of doctors and 71% of nurse practitioners and physician assistants said their computer use at work had increased in the past year, with 22% of doctors and 19% of nurse practitioners and physician assistants reporting less time in face-to-face interactions with patients.

Only about 5% of study participants reported that they had an "expert knowledge" of ergonomics. Furthermore, more than two-thirds said they had no input in the planning or design of their computer or clinical workstation, the authors noted. The researchers surveyed 180 physicians and 63 nurse practitioners and physician assistants for the study.

In a statement, Hedge said that with so many potentially negative effects for doctors and patients, it's critical that new technology implementation be considered from a design and ergonomics perspective.

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