“Our clinicians are caught in the middle of an arms race between payers and providers.”
“A lot of us feel like we’re being used by the EMR.”
“We’re in a vicious cycle.”
When three influential healthcare leaders — all of whom are physicians — were asked during a recent webinar to describe how documentation requirements effect care givers, they didn’t hold back. It’s one of the most daunting issues in healthcare; one that needs to be addressed before things get worse.
Thankfully, our panelists — Tonya Hongsermeier, MD, VP and CMIO of Lahey Health; Stephanie Lahr, MD, CIO and CMIO at Monument Health; and Sean Kelly MD, CMO at Imprivata — didn’t waste time sugarcoating it. Instead, they discussed the main challenges providers feel in relation to burnout, what their organizations are doing to mitigate them, and how the industry as a whole can push for change.
The speakers started by defining the scope of the problem, something that unfortunately wasn’t difficult to do. “Our clinicians are drowning,” said Hongsermeier. “The EMR has become the receptacle of administrative overhead.” As a result, clinicians “spend more time curating the data than curing patients, and it’s painful for them.”
Kelly, who has logged nearly 20 years as an emergency physician at Beth Israel, concurred, adding that technology needs to work for — not against — care providers. “The job is hard enough as it is.”
As research has shown, this frustration can negatively impact productivity and, more importantly, interfere with care. As a result, burnout is becoming a critical priority, according to Hongsermeier, who participated in statewide collaborative designed to increase awareness and provide best practices. “It needs to be top of mind,” she noted.
The most effective way to do that? Not just by showing what doesn’t work, but also what does, noted Kelly. “The idea is to facilitate and make technology invisible so doctors and nurses can do their jobs,” and keep their focus on the patient. That means asking questions like, how do users want to operate when they log into the EHR? Can things be automated in the background to reduce wait times?
Time, however, isn’t the only concern. It’s also about limiting interruptions, he added. Physicians shouldn’t be stopped and asked to remember a password, or worse, deal with being locked out. “You can’t break the thought process.”
It’s a quandary Imprivata is addressing by creating a “borderless environment” that leverages tools like digital workspaces to enable clinicians to securely access charts from different locations, and uses proximity awareness and low-energy Bluetooth to help physicians work more efficiently.
“(Current EHRs) .. are optimized for billing; not for patient care,” he said. “We didn’t go to school to become scribes or data clerks. We don’t mind working hard. But if we spend 85 percent of our time documenting and ordering, it’s not satisfying. It keeps you from providing the best care.”
It can also cause physicians to become so overwhelmed they start to push back on everything and are willing to forego the good as well as the bad when it comes to EHRs, according to Lahr. This is where leaders have an opportunity to showcase the benefits of technology by providing tools like badges that ease the sign-in process.
There are other critical steps organizations can take, including the following:
- Use the entire toolkit. At Lahey, Hongsermeier’s team is relying on several different methods to make sure clinicians feel heard, starting with a governance model that involves “a lot of clinician participation in how we make configuration decisions around the EMR.” They’ve also made a significant investment in training and support, conducting outreach with specialty areas, ensuring engagement with operations, and making positive adoption stories viral. “It’s a multi-pronged strategy,” she said.
- Get technologists on the floor. It’s imperative to get clinical engineers, analysts, and others on the floor “to see firsthand what doctors are and aren’t doing, where frustrations lie, and how it effects their ability to do their jobs,” said Lahr.
- Collaborate and listen. By participating in initiatives like KLAS’ Arch Collaborative, leaders can compare their user experiences with those in other organizations, and learn what solutions are — and are not — helping to reduce frustration. “We’re all becoming data-driven; it makes sense to measure this,” Lahr stated. And although they’re not a silver bullet, comparisons with similar organizations can “let you know if you’re in crisis mode and bring resources to bear.”
- Get innovative. Bear in mind, innovation doesn’t have to be done on a grand scale to make a difference. “Real innovation happens when organizations are able to operationalize the tools we have,” and use them in more effective ways, said Hongsermeier. As an added bonus, creativity and ingenuity don’t cost anything. What leaders need to bear in mind is that innovation is just as much about culture and change management as it is about shiny toys, noted Kelly. “Just putting something on high speed doesn’t make it better. We need to forget about ‘AI’ for a little while and just focus on the ‘I.’”
Finally, leaders need to realize that solutions are already out there, and that there’s a lot to be gained by sharing experiences — even the negative ones. “Communication is essential,” said Kelly. “We have to work together collaboratively to make a bigger impact.”
To view the archive of this webinar — An IT Executive’s Guide to Reducing Physician Burnout (Sponsored by Imprivata) — click here.