By Joel A. Kahn M.D., First Line Software
Systemic problems plague the healthcare industry.
We’ve all heard the discussions surrounding physician burnout. Demanding schedules, stressful situations, lack of time to connect with patients, and lack of sleep are just a few factors that can lead to emotional exhaustion and sap motivation for physicians and other healthcare workers. Recent research also shows that physician burnout doubled the odds of involvement in patient safety incidents.
However, while the term “physician burnout” is a real problem the causes of it are myriad and affect more than just physicians. For example, nurses also report that they feel burned out or “unengaged” as do social workers. We also cannot put the solution to this problem entirely on our providers. While it is easy to push for solutions to help them ease emotional stress – such as offering more mental healthcare options, stress reduction programs, etc. – the real issues lie in the systemic problems plaguing the healthcare industry. The administrative burden being one of the largest problems. Federal and insurance requirements for documentation of practically all activities has put a significant burden on physicians.
Physicians cannot solve this problem on their own. There is some evidence that physician burnout is easing with the right tools in place. Automated clinical tools that are integrated into the physician workflow can assist rather than burden the physician in providing quality care.
What Is Currently Being Done To Ease Administrative Burden?
A 2018 survey found that 83 percent of clinicians, clinical leaders and healthcare executives see physician burnout as either a “serious” or “moderate” problem at their organization. Additionally, 68 percent said that the problem has worsened at their organizations over the past two to three years.
“Interventions must be targeted at multiple levels: provider organizations, regulators (specifically around payer/documentation requirements), the work unit leader, and individual clinicians,” the report said.
System and infrastructure improvements, along with regulatory changes and individual interventions (i.e., concentrating on self-care) were all cited as ways to cut down on burnout, according to the survey. Several of these approaches are already happening, but healthcare must ensure that it continuously works toward positive change.
For example, the CMS issued a request for information (RFI) in June 2019 for suggestions on how to further reduce administrative burden through the Patients Over Paperwork initiative. First launched in 2017, Patients Over Paperwork was designed “to reduce unnecessary burden, to increase efficiencies, and to improve the beneficiary experience” and work on “removing regulatory obstacles that get in the way of providers spending time with patients.”
In addition to federal regulations, organizations are opting for advanced workflow technologies that can further automate the documentation process. Natural language processing (NLP) and voice or speech recognition software can further assist with clinical documentation improvement (CDI) and EHR usability to help eliminate some physician EHR data entry requirements.
EHR adoption means more data, and subsequently, more reporting and analytical processing. Existing infrastructure and IT resources are being pushed to their limits, and physicians are often the ones left trying to make sense of all that data. Not only are physicians trying to care for patients to the best of their ability, but they must also consider the administrative requirements involved.
It’s critical to help physicians extract, transform and standardize data across multiple systems. Whether it’s a hospital, health system or outpatient center, providers need the right combination of a custom system with the necessary integration tools to streamline how healthcare data is used.
Learning From Other Industries For True Automation
The onset of EHRs helped to fuel administrative burden. While the digitization of medical records was meant to simplify care by cutting down on paper, ensuring that information can be accessed anytime and anywhere, this has not been the case.
EHRs don’t make it easy to input data or to extract it. One of the main EHR goals was to have a more efficient way to communicate. With everything being electronic, it should be easier to transmit and receive patient data, which would create better patient care. But as interoperability barriers and privacy and security concerns demonstrate, it’s not that easy to properly access and utilize healthcare data.
Truly innovative solutions need to be system wide and built for physicians – not just the administration. Solutions cannot be siloed for each department within a healthcare organization (i.e., patient safety, antibiotic committee). With the abundance of data currently available in healthcare, it’s critical to focus on tools and infrastructure that makes physicians’ lives more efficient and less burdensome.
The travel industry, for example, has truly mastered this approach to automation. Customers can book a flight, hotel stay, and rental car all from one website. Then flight information is accessible through a smartphone app, with any changes or cancellations sent directly to the customer. Individuals can check in to their flight, opt for seat upgrades and even see which baggage claim their luggage will be sent to after landing. Healthcare must develop the ability to offer the same all-inclusive, streamlined experience.
Patients should be able to schedule and change appointments through a smartphone app, communicate securely with their physician and be notified of any changes. Whether a patient moves or visits a different health system, her information should still be accessible both to her and to the physician attending to her. When healthcare organizations are utilizing a truly automated system that allows for more engaged physicians and clinicians, everyone benefits.
Using Data Efficiently, Effectively For Long-Term Success
With technology continuing to evolve, and healthcare increasingly collecting – and creating – data, we need to ensure that all data is being utilized in an efficient and cost-effective way. It is estimated that $4.6 billion in costs related to physician turnover and reduced clinical hours is attributable to burnout each year in the U.S. Within that, the annual economic cost associated with burnout related to turnover and reduced clinical hours is approximately $7,600 per employed physician each year.
Policy changes at the federal level can help to ease administrative burden, but healthcare organizations must also invest in systems and tools designed for improved EHR usability.
Clinicians and health IT vendors must collaborate before, during and after any EHR optimization projects or EHR interface design. Higher provider satisfaction, paired with improved clinical efficiency, lets providers focus more on patient care delivery than administrative tasks. We have the ability to help physicians get to that next level of patient care. It’s time we take that necessary step forward to make long-lasting, positive change for the entire healthcare ecosystem.
About The Author
Dr. Joel A. Kahn is the Chief Medical Officer of First Line Software where he focuses on driving their global health solutions. He has been exploring the intersection of business, healthcare and technology for more than 25 years and has been focused on executive management, operations, compliance, analytics, technology and their application in the healthcare and wellness industry.