Reducing Physician Burnout due to EHRs

Technology is aimed at making our lives easier and simple – however, the transition stages seem to make life more difficult and tough.  A typical example is the Electronic Health Record (EHR) system.  While EHR use has definite benefits for patient safety and quality of care, it is also causing frustration amongst physicians and other medical professionals.

EHR use has found acceptance across the country with 97% of hospitals and 75% of physicians already using it.  Even though EHRs are here to stay, its use seems to be contributing to physician burnout and interfering with patient care.  According to surveys, primary care physicians and emergency physicians feel that their facilities are not effectively addressing physician burnout, with EHR use and time pressures identified as the biggest causes for frustration.

A recently published survey result from The Annals of Internal Medicine, reports that nearly 50% of the office time for physicians is spent working on EHR inputs.  Compare this to a mere 27% that is spent with patients directly.  And this does not end at the office – doctors spend an average of one to two hours at home completing and updating EHRs.  A similar finding by a Medscape survey, reports that 57% of physicians stated that EHR use reduced face-to-face patient interaction while 50% said that EHRs limited the number of patients they could see.

Exacerbating physician burnout; the mounting pressure from frustrated clinicians and management, in turn, is impacting health IT workers’ stress and job satisfaction.  A recent HealthITJobs.com survey found that 55% of health IT workers are stressed with 38% citing high or extremely high stress.  However, healthcare organizations can prevent provider burn out; improve clinical workflow efficiency and job satisfaction by optimizing their EHR and other clinical IT systems.  Organizations can identify and quantify the daily challenges their providers are facing and then through a careful assessment of IT systems and processes, design strategic solutions for high-quality patient care.

Negative repercussions of EHR burnout will likely influence the future of healthcare industry. Some examples of these repercussions could be:

Declining physician pool: According to a survey by Physicians Foundation, almost 50% of physicians plan to cut back on their working hours, retire or opt for non-clinical jobs due to burnout.  This is likely to cause a shortage of physicians and with the aging US population, seems to be heading for a disaster.

New or future physicians: Burned-out medical students are more likely to engage in patient care misconduct and endorse unprofessional behaviour, states a study by the American Medical Association.  Burnt-out medical students, who typically practiced with physician mentors, were also found to hold less altruistic views of their role as physicians in society.

Care quality: Physician burnout may also lead to lower care quality, increasing medical error, risks of malpractice and patient dissatisfaction, which can end up reducing payment under value-based care reimbursement models.

Pessimism: Most medical professionals are pessimistic about the future of their profession, according to the survey, with one-third indicating they wish they had chosen a different career and nearly 50% recommending different career paths to their children.

However, providers are not completely opposed to EHR use and agree that some features do increase satisfaction to combat burnout.  According to a survey of more than 15,000 physicians across 25 care specialties, nearly 62% of physicians deemed e-prescribing as the most useful EHR feature, while 57% ranked easy review of patient information as the second highest,. Standing third at 49% were the ability to share patient records and lab results, conduct drug/allergy checks and incorporate clinical lab test results. The survey also found that 56% of physicians believed that EHR use effectively improved the documentation at their practices with 81% planning on keeping their current EHR system.

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EHR usability is one of the main stressors for both health IT staff and end users.  Organizations can implement vendor scorecard metrics on patient-provider interaction time and after-hours documentation and then analyze data to identify excessive EHR-related usage time to improve patient care and physician/patient experience.

More intuitive user interfaces and templates to support efficient clinical workflows and physicians’ natural thought patterns will improve EHR navigation.  Aligning processes with industry best practices for structured-form workflows, and working with vendors for task sequence customizations to fit work habits, will go a long way in helping EHR use.  Documentation requirements and actual end-user entry need to align, focusing on standardization and simplification of only the most meaningful data.

Health IT staff must properly train and transition end users to be comfortable with and invested in the EHR system.  All stakeholders need to feel they are within a culture where they are inspired, valued and vital to the overall organizational goals and enterprise-wide patient care experience.


References

  1. 2016 SURVEY OF AMERICA’S PHYSICIANS. (2016). Retrieved October 24, 2016, from http://www.physiciansfoundation.org: http://www.physiciansfoundation.org/uploads/default/Biennial_Physician_Survey_2016.pdf
  2. Kyle Murphy, P. (2016, March 28). Ensuring Physician EHR Use Doesn’t Lead to Physician Burnout. Retrieved October 24, 2016, from http://www.ehrintelligence.com: https://ehrintelligence.com/news/ensuring-physician-ehr-use-doesnt-lead-to-physician-burnout
  3. Liselotte N. Dyrbye, M. M., F. Stanford Massie, M., & Anne Eacker, M. (2010, September 15). Relationship Between Burnout and Professional Conduct and Attitudes Among US Medical Students. Retrieved October 24, 2016, from http://www.jamanetwork.com: http://jamanetwork.com/journals/jama/fullarticle/186582
  4. Medscape EHR Report 2016. (2016). Retrieved October 24, 2016, from http://www.medscape.com: http://www.medscape.com/features/slideshow/public/ehr2016
  5. Stoltenberg, S. (2016, October 07). Tips for Reversing Physician Burnout Caused by EHR Use. Retrieved October 24, 2016, from http://www.ehrintelligence.com: https://ehrintelligence.com/news/tips-for-reversing-physician-burnout-caused-by-ehr-use

 

 

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