The impact of clinician burnout has been a top story for years, heightened by the extra stress and burden of the pandemic, costing the U.S. healthcare system about $4.6 billion annually. And, by some estimates, 47% of U.S. healthcare workers may leave the profession by 2025. One of the most common sources cited as contributing to burnout is electronic health records (EHRs). According to a Stanford Medicine poll, 71% of physicians reported that EHRs contribute to burnout, and six out of 10 (59%) think EHRs need a complete overhaul.
In an effort to address these concerns, the Department of Health and Human Services (HHS) released an overarching strategy in 2020 to reduce clinician burden associated with entering information into EHRs, meeting regulatory requirements and improving EHR ease of use. Yet, a recent editorial published in JAMA Network states that clinicians still feel burdened with EHRs that prioritize administrative, financial, and regulatory needs over clinical workflow. The article asserted that clinicians and their patients deserve a “patient-centered, technology-enhanced health care ecosystem that is designed to significantly improve outcomes at a lower cost.”
At the heart of clinician frustration with EHRs is time. Clinicians report that they spend nearly twice as much time doing manual, EHR-related tasks as they spend with patients. Hospital-based physicians reported spending 37 minutes on behalf of each patient – 25 of which was spent in the EHR, according to a Stanford Medicine poll.
Making EHRs work with and not against clinicians is possible. When EHRs take a human-centered design approach, collaborating closely with clinicians to optimize workflows, the EHR can stop being the focus of clinicians’ days, and instead support them as they provide care to patients. There are five important ways EHRs can help alleviate clinician burnout.
- Collaborate with clinicians
Today’s EHRs need to be designed in collaboration with clinicians – physicians, nurses, pharmacists, lab and radiology technologists, therapists – to create workflows that are adaptive to clinicians and intuitive to use. Only with their input can we stop making the EHR the focus of their time, but the supporter of their most efficient patient care processes.
The key is to focus on the needs of each clinician and the task at hand to make adaptive, efficient use of screen real estate for reviewing information and for taking the next action for the patient. Clinical and non-clinical staff alike appreciate consistent and efficient workflows which save time and reduce frustration.
- Automate data assimilation within workflows
Data integration may be complex, but it’s possible and practical with today’s technology. By taking advantage of standard integration protocols, such as Application Programming Interfaces (API), EHRs can create user-focused workflows that automatically integrate data from sources outside the EHR. Instead of requiring nurses to enter data from external devices into the EHR, a time-consuming and error-prone manual activity, the EHR should be fully integrated with bedside monitoring and other devices to create efficient workflows. Once the data is in the EHR, the EHR can perform calculations automatically, and present that data within the workflow.
The value to clinical staff is significant. For example, using advanced integrations, nurses working with monitored patients report saving as much as 15 to 20 minutes per patient per shift. Eliminating manual tasks not only saves time, but also improves accuracy, freeing clinicians to focus their attention on patient care.
- Make documentation a natural byproduct
Given that documentation has become one of the biggest frustrations for clinicians, it’s important that EHRs move beyond the focus on transactions – placing orders, viewing results, entering documentation – to a focus on creating smooth, efficient, and supportive workflows for physicians, nurses, and other clinicians. By adapting to user actions and prioritizing the information that is clinically useful, EHRs can facilitate clinical decision-making.
One example of a critical process that is often cumbersome and frustrating for clinical staff is medication reconciliation. A well-designed EHR workflow can make this process both accurate and fast by presenting a side-by-side comparison of what’s current and what’s needed for the patient, making it easy for the physician to take action on medications. Integrating this process within the natural workflow reduces frustration, saves time, and improves patient care.
- Meet clinicians where they are
One of the biggest challenges for clinicians is interruption. In one study, physicians were interrupted more than 12 times on average during patient rounds, often via text messages. And in our increasingly mobile society, clinicians are always on the move and expect to have what they need to make care decisions wherever they are.
EHRs can streamline care processes and reduce reliance on text messaging by delivering the right information to clinicians in ways that adapt to their workflow. Instead of disjointed messages, the EHR can bring together the information about the patient in one place and tee up key actions relevant at that time, such as during rounds or when preparing for discharge. For example, during rounding, the EHR can present a consolidated view of the patient with an intuitive process for managing their care. For physicians, nurses, and other clinicians, the EHR can reduce stressful interruptions, while supporting better patient care processes.
Most EHRs require planned downtime for system maintenance and upgrades. During these times when the EHR is unavailable, clinicians are required to use workarounds and paper-based processes, reducing productivity. Moreover, nearly all organizations experience unplanned EHR downtime, 96% in one study. Another study found that 70% of organizations experienced at least one unplanned downtime lasting eight hours or more. Long periods of unplanned downtime disrupt operations, puts patient safety at risk and negatively affects revenue.
Instead, EHRs can be built upon modern foundational architectures that don’t require downtime for routine maintenance and upgrades and have built-in redundancy to prevent unplanned downtime. In addition, with a focus on reliability, EHRs can prevent unplanned outages, while delivering the high-speed performance and data protection health systems require. Eliminating both scheduled and unscheduled downtime can eliminate the reliance on manual workflows that lack access to vital patient information – and remove a common source of stress for clinicians.
Bringing joy back to healthcare
When clinicians are leaving their chosen profession in droves and many say EHRs need a complete overhaul, it’s time for the industry to listen. With thoughtful use of technology and a collaborative approach with clinical staff, EHRs can become the supportive tools they are intended to be. Instead of being the focus of clinicians’ days, EHRs can become much more effective, making patient care more efficient. Ultimately, EHRs should contribute to clinician wellness, allowing the joy of helping others back into their work and enabling them to provide the highest quality patient care.
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