{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:34:51Z","timestamp":1774953291629,"version":"3.50.1"},"reference-count":62,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T00:00:00Z","timestamp":1723507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"American Medical Informatics Association (AMIA)'s 25\u2009\u00d7\u20095 Task Force"},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"crossref","award":["AHRQ 1HS028454-01A1"],"award-info":[{"award-number":["AHRQ 1HS028454-01A1"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objectives\u2003Efforts to reduce documentation burden (DocBurden) for all health professionals (HP) are aligned with national initiatives to improve clinician wellness and patient safety. Yet DocBurden has not been precisely defined, limiting national conversations and rigorous, reproducible, and meaningful measures. Increasing attention to DocBurden motivated this work to establish a standard definition of DocBurden, with the emergence of excessive DocBurden as a term.<\/jats:p><jats:p>\n          Methods\u2003We conducted a scoping review of DocBurden definitions and descriptions, searching six databases for scholarly, peer-reviewed, and gray literature sources, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extensions for Scoping Review guidance. For the concept clarification phase of work, we used the American Nursing Informatics Association's Six Domains of Burden Framework.<\/jats:p><jats:p>\n          Results\u2003A total of 153 articles were included based on a priori criteria. Most articles described a focus on DocBurden, but only 18% (n\u2009=\u200928) provided a definition. We define excessive DocBurden as the stress and unnecessarily heavy work an HP or health care team experiences when usability of documentation systems and documentation activities (i.e., generation, review, analysis, and synthesis of patient data) are not aligned in support of care delivery. A negative connotation was attached to burden without a neutral state in included sources, which does not align with dictionary definitions of burden.<\/jats:p><jats:p>\n          Conclusion\u2003Existing literature does not distinguish between a baseline or required task load to conduct patient care resulting from usability issues (DocBurden), and the unnecessarily heavy tasks and requirements that contribute to excessive DocBurden. Our definition of excessive DocBurden explicitly acknowledges this distinction, to support development of meaningful measures for understanding and intervening on excessive DocBurden locally, nationally, and internationally.<\/jats:p>","DOI":"10.1055\/a-2385-1654","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T23:30:01Z","timestamp":1723591801000},"page":"898-913","source":"Crossref","is-referenced-by-count":22,"title":["Defining Documentation Burden (DocBurden) and Excessive DocBurden for All Health Professionals: A Scoping Review"],"prefix":"10.1055","volume":"15","author":[{"given":"Deborah R.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Pain Research Informatics Multimorbidities and Education Center, VA-CT, West Haven, Connecticut, United States"},{"name":"Department of Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, Connecticut, United States"}]},{"given":"Jennifer B.","family":"Withall","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Columbia University, New York, New York, United States"}]},{"given":"Rebecca G.","family":"Mishuris","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States"}]},{"given":"Victoria","family":"Tiase","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, Utah, United States"}]},{"given":"Courtney","family":"Diamond","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Columbia University, New York, New York, United States"}]},{"given":"Brian","family":"Douthit","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States"},{"name":"Department of Veterans Affairs, Tennessee Valley Health System, Nashville, Tennessee, United States"}]},{"given":"Monika","family":"Grabowska","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States"}]},{"given":"Rachel Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Columbia University, New York, New York, United States"}]},{"given":"Amanda J.","family":"Moy","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Columbia University, New York, New York, United States"}]},{"given":"Patricia","family":"Sengstack","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States"},{"name":"Vanderbilt University Medical Center, School of Nursing, Nashville, Tennessee, United States"}]},{"given":"Julia","family":"Adler-Milstein","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics and Digital Transformation, Department of Medicine, University of California, San Francisco, San Francisco, California, United States"}]},{"given":"Don Eugene","family":"Detmer","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, United States"}]},{"given":"Kevin B.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine; University of Pennsylvania, United States"},{"name":"Applied Informatics, University of Pennsylvania Health System, Philadelphia, Pennsylvania, United States"}]},{"given":"James J.","family":"Cimino","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics and Data Science, University of Alabama at Birmingham, Birmingham, Alabama, United States"}]},{"given":"Sarah","family":"Corley","sequence":"additional","affiliation":[{"name":"MITRE Corporation, Center for Government Effectiveness and Modernization, McLean, Virginia, United States"}]},{"given":"Judy","family":"Murphy","sequence":"additional","affiliation":[{"name":"Indepdendent, Minneapolis, Minnesota, United States"}]},{"given":"S. Trent","family":"Rosenbloom","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States"}]},{"given":"Kenrick","family":"Cato","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia and University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States"}]},{"given":"Sarah C.","family":"Rossetti","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Columbia University, New York, New York, United States"},{"name":"Columbia University School of Nursing, New York, New York, United States"}]}],"member":"194","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"949","DOI":"10.2215\/CJN.14191119","article-title":"The electronic medical record and nephrology fellowship education in the United States: an opinion survey","volume":"15","author":"C M 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