An Organizational Routines Theory of Employee Well-Being: Explaining the Love-Hate Relationship Between Electronic Health Records and Clinicians

Authors

Ankita Srivastava, Bentley UniversityFollow
Surya Ayyalasomayajula, Arizona State UniversityFollow
Chenzhang Bao, Oklahoma State UniversityFollow
Sezgin Ayabakan, Temple UniversityFollow
Dursun Delen, Oklahoma State University / Istinye UniversityFollow

Abstract

We study the problem of clinician well-being, through the lens of burnout, using an alternate source of data—a large, unstructured, publicly available dataset comprising 55,441 reviews written by clinicians on Glassdoor.com from 2012 to 2020. First, we employed topic mining and qualitative coding methods to identify contributing factors to clinician well-being and drew comparisons with electronic health records (EHR), a well-studied yet controversial factor in clinician burnout. Surprisingly, EHR- or IT-related keywords were not prominent in the clinicians’ discourse. Instead, routine operations emerged as the most frequently mentioned topic in the pros and cons sections of the reviews. Since routine operational issues are influenced by IT use, we leveraged organizational routines theory and application integration theory to propose a midrange “routines theory of employee well-being” that explains how managing organizational routines through IS can help improve clinician well-being. We tested the proposed theory using econometric models and found that integrating workflow applications significantly enhanced clinician well-being. In contrast, integrating documentation applications did not exhibit a significant impact. Interestingly, we also observed that the effects of integrating workflow and integrating documentation were more pronounced in hospitals with higher ratings of work-life balance or lower patient-to-nurse ratios, highlighting the critical role of staffing levels in driving the impact of EHR integration on clinician well-being. Overall, this is the first study to theorize and unravel the latent, intricate relationship between EHR and clinician burnout, which is moderated by organizational factors such as work-life balance policies and staffing levels.

Recommended Citation

Srivastava, Ankita; Ayyalasomayajula, Surya; Bao, Chenzhang; Ayabakan, Sezgin; and Delen, Dursun (2025) "An Organizational Routines Theory of Employee Well-Being: Explaining the Love-Hate Relationship Between Electronic Health Records and Clinicians," Journal of the Association for Information Systems, 26(3), 589-632.
DOI: 10.17705/1jais.00940
Available at: https://aisel.aisnet.org/jais/vol26/iss3/9

DOI

10.17705/1jais.00940