Interoperability, User-Centered EHR Design Key to Tackling Clinician Burnout

Health data interoperability and user-centered EHR design can help address administrative burdens that contribute to clinician burnout, according to an advisory from Vivek Murthy, MD, MBA, Surgeon General.

Murthy said that healthcare organizations should implement strategies to reduce administrative burdens so providers can spend more time with patients.

For example, de-implementation checklists can help address common administrative burdens in the workplace. Hawaii Pacific Health's "Getting Rid of Stupid Stuff" program asked providers to assess their EHR experience and nominate tasks to eliminate that they found unnecessary or poorly designed. Ultimately, the initiative helped the health system save 1,700 nursing hours per month.

The Surgeon General also emphasized prior authorization's role in driving clinician burnout. A 2020 survey found that 85 percent of physicians described the burden associated with prior authorization as high or extremely high. Electronic prior authorization could help address clinician burnout and drive efficiencies.

"According to the 2020 CAQH Index, which tracks adoption of HIPAA-mandated and other electronic administrative transactions for conducting routine business between healthcare providers and health plans, electronic prior authorization could save $417 million annually," he wrote. "Transitioning to a fully electronic prior authorization process would also save health workers up to 12 minutes per transaction."

Additionally, a 2018 report from the Office of the Inspector General (OIG) found high rates of inappropriate prior authorization requests.

"To change this, healthcare organizations, health systems, medical groups, and payors can commit to regularly review and revise the need for prior authorizations requirements, and improve transparency, communication, and timely resolution of prior authorization requests," Murthy wrote.

He also emphasized the role EHR vendors and health IT companies play in addressing burnout. Vendors should work with healthcare workers to design and improve EHRs to be easily accessible and efficient, Murthy said.

"Priority opportunities include examining factors that may be contributing to information overload, clinical decision complexity, and interruptions," the Surgeon General wrote.

For example, EHR vendors can reduce pop-up messages to minimize work interruptions, improve EHR integration into daily workflows, and curate data to visualize patient health history better.

Murthy said that ensuring health data interoperability in EHRs could also help address clinician burnout.

"Technology companies can ensure that patient-generated data is accessible in a meaningful way and does not result in increased burdens on health workers," he explained. "This includes improvements in interoperability to optimize communication between and across disparate systems and sources, such as care teams, laboratories, and public health."

Murthy said that strengthening the integration of data across different platforms and health sectors allows for a more complete picture of a patient's health while promoting care coordination.

The Surgeon General also pointed to the importance of research to examine how to design and develop effective health IT.

"This could include research into the development and validation of effective measures, including impact on productivity, utilization, morale; and how to incorporate evaluation findings into systems improvement," he wrote.