Information overload in emergency medicine physicians: a multisite case study exploring the causes, impact, and solutions in four North England National Health Service Trusts

Background: Information overload is more than ever affecting modern society due to the wide and increasing distribution of digital technologies. Social media, emails, online communications among others infuse a sense of urgency as information must be read, produced and exchanged almost instantaneously. Emergency medicine is a medical specialty particularly affected by information overload with consequences on patient care that are difficult to quantify and address. Understanding the current causes of medical information overload, their impact on patient care and strategies to handle the inflow of constant information is crucial to alleviating the stress and anxiety already crippling the profession.

Objective: This study aims to identify and evaluate the main causes and sources of medical information overload as experienced by emergency medicine physicians (EMPs) in selected NHS Trusts in the UK.

Methods: This study utilises a quantitative, survey-based, data collection approach including close and open-ended questions. An online survey was distributed to emergency physicians to assess the impact of medical information overload in their job. In total, 101 valid responses were collected from four National Healthcare System (NHS) Trusts in the north of England. Descriptive statistics, Principal Component Analysis (PCA), independent sample t-tests and one-way between-groups ANOVA with post-hoc tests were performed on the data. Open-ended questions were analysed using thematic analysis to identify key topics.

Results: The vast majority of respondents agreed that information overload is a serious issue in emergency medicine and it increases with time. The “always available” culture (mean=5.40), email handling (mean=4.86) and multidisciplinary communications (mean=4.51) are the three main reasons leading to information overload. Because of this, emergency physicians experience ‘guideline fatigue’, stress and tension, longer working hours and impaired decision-making among other issues. Aspects of information overload are also reported to have different impacts on physicians depending on demographic factors such as age, years spent in emergency medicine and level of employment.

Conclusions: There is a serious concern regarding information overload in emergency medicine. Participants identified a considerable number of daily causes affecting their job, particularly the traditional culture of emergency departments being always available on the ward, exacerbated by email and other forms of communication necessary to maintain optimal, evidence-based practice standards. However, not all information is unwelcome, as physicians also need to keep up-to-date with the latest guidelines on conditions and treatment as well as communicate with larger medical teams to provide quality of care.