From burden to benefit: strategies to overcome barriers in electronic health record optimization

Purpose of review This review examines barriers to electronic health record (EHR) optimization more than a decade after widespread adoption, with a focus on usability limitations, workflow misalignment, interoperability gaps, documentation burden, clinician burnout, and organizational challenges. It synthesizes recent evidence regarding how these issues undermine efficiency, clinician wellbeing, and care quality, while evaluating emerging strategies – such as human-centred design, enhanced training, clinician-led governance, and AI-powered documentation tools – that offer promise for transforming EHRs from a source of burden into an enabler of high-quality care. Recent findings Recent studies highlight that EHR systems continue to impose significant cognitive and administrative load, contributing to emotional exhaustion and burnout on clinicians. Large multisite analyses show that up to 60% of clinicians experiencing burnout attribute it partly to EHR use, driven by complex workflows, non-intuitive systems and lack of integrations between multiple platforms. Evidence also confirms continued usability failures, workflow inefficiencies, and interoperability gaps that fragment information and disrupt care. However, recent evaluations demonstrate that strategies such as human-centred redesign, structured role-based training, governance models with strong clinician involvement, streamlining workflows, and adoption of AI-powered documentation tools can significantly reduce documentation time, improve usability, and lower burnout indicators. Summary EHR optimization remains essential to achieving safer, more efficient, and sustainable healthcare delivery. Persistent barriers – including poor usability, workflow misalignment, technical and interoperability constraints, and documentation burden – continue to limit EHR effectiveness and negatively affect clinician perception and wellbeing. Emerging evidence shows that meaningful progress requires a holistic approach grounded in human-centred design, robust organizational support, technological standardization, and workflows that align with real clinical practice. When combined with innovations such AI-powered documentation tools and improved data integration, these strategies can shift EHRs from contributing to clinician burden to supporting high-quality, patient-centred care.