Reducing Clinician Burnout While Improving Quality of Care
In This Article
The COVID crisis has put the issue of clinician burnout front and center in the healthcare industry. However, the problem has been growing for some time.
In November of 2019, a survey of more than 5,000 clinicians, jointly published by the Mayo Clinic and the American Medical Association (AMA), indicated that clinicians blamed "high volumes of data entry and poor usability associated with electronic health records (EHRs)" as main causes behind physician burnout.
While clinicians believe EHRs serve the purpose of streamlining regulatory and billing requirements, they also think EHRs fall short of the promise of improving healthcare delivery. Though imperfect, the technology itself may be shouldering the blame for other contributing factors slowing healthcare delivery, like regulatory mandates, clinical volumes, and mismatching technology selections with clinician needs.
For their part, EHR software companies have increased the adoption and maturity of user-centered design practices (at least according to a 2021 survey performed by the Journal of the American Medical Informatics Association. In addition, these organizations have begun to recognize that partnering with informatics innovators can improve usability and relieve clinician burnout. For example, a block-randomized study recently published in the same journal found that when clinical data included problem-oriented summaries built into an EHR, "clinicians across three academic medical centers were able to retrieve data faster and with fewer errors."
Regardless, clinician burnout has reached critical levels, with estimates ranging from 35 to 54 percent of all U.S. nurses and physicians depending on the study. In the pandemic's wake, employees across industries have left left jobs. This Great Resignation has left many healthcare systems critically understaffed. While pointing the finger at EHR adoption is a simple answer, the reality is that technology, informatic innovations and policy-based solutions are all critical to preventing or relieving burnout.
A changing landscape
Part of the solution may require a cultural change within healthcare organizations. For example, by shifting organizational focus from appointment volume to quality of care. Recognizing and protecting the clinician's time for documentation, rather than assuming it can be squeezed into an already-shortened appointment window, can greatly reduce the valuable time clinicians spend with patients. Designing team-based care workflows can distribute tasks more evenly across several clinicians to help mitigate burnout. Even utilizing automation to reduce administrative burdens that bring no value to the patient's care can better align clinicians' focus on improving care delivery.
The inefficiency of current EHR systems aside, technology remains a solution to reducing workload and improving the overall clinician experience if planned and implemented correctly.
The selection and design of technology tools must consider how clinicians think and work. The healthcare system just underwent several years of EHR implementation, training and adoption with very little perceived care delivery benefit. With this memory fresh in their minds, some practitioners may be skeptical of adopting new technologies for some time.
This can be alleviated by ensuring clinician feedback during the solution selection or development process. We've helped many of healthcare clients map the why behind clinicians' day-to-day tasks, then designed technology interfaces that reduce complexity and are intuitive to the users. For example, simplifying the number of clicks needed to accomplish tasks alone reduces administrative burden and frees time.
It's important to remember that the clinician experience often spills over into the patient experience. For example, a physician who needs to run a lab on a patient will perform due diligence to ensure the test has not already been run, tediously searching through multiple previous encounter notes, lab reports and primary care history. If the data can't be located with a minimum of clicks, the doctor may simply decide to run a test that has already been done, driving up the overall cost and inconveniencing the patient.
The right information, right now
Rather than clicking through a patient chart, artificial intelligence (AI) and machine learning (ML) tools can be leveraged to access the data clinicians need, when they need it, to make more efficient decisions at the point of care.
In theory, algorithms that help clinicians diagnose and treat patients based on information from EHRs and from other data sources (medical devices, labs, etc.) can be helpful. Still, they are no replacement for the clinician's experience and skill. Instead, AI/ML can be leveraged to support a clinician's decisions. Overburdened clinicians often struggle to find the hours needed to manually research essential details about underlying conditions, contraindications or medication efficacy. By identifying and interpreting the myriad of often disorganized and always complex patterns of information, AI/ML can deliver the relevant and actionable data needed to minimize the amount of time required to create a diagnosis and treatment plan.
AI can help in other ways as well. For example, double shifts can be reduced by leveraging AI to analyze real-time patient flows for insights into workload forecasting. In addition, with the increasing usage of value-based payer contracts, AI could potentially automate the collection of critical success outputs, minimizing the burden on the providers.
Improving health outcomes
As they introduce new technology and tools to existing clinical systems, clinicians remain focused on delivering safe and efficient patient care. For example, modern IoT devices can provide remote monitoring that not only limits clinician exposure to contagions but move health monitoring out of the hospital and into a patient's home. These same solutions can be leveraged to improve hospital discharge care, chronic care patient outcomes by alerting care teams to decompensating events, or even compliance with treatment plans.
Virtual care has provided a much-needed access point for patients during the pandemic. But it can also become an everyday tool to help make better clinical decisions. With the reduction of the clinical workforce, many clinicians, especially those in rural areas, do not have robust healthcare resources. They simply "do what it takes" to treat patients, sometimes beyond the scope of their practice. With telehealth technology, these clinicians can access specialists around the world through remote consultations.
Clinicians entered the healthcare field to help people. Job satisfaction comes from delivering care at the top-of-license. As the healthcare system introduces more complexity, leveraging technology to reduce administrative tasks and increase clinicians' time with patients may be the key to recruiting and retaining top talent.