- Commemorating National Health IT Week, President Obama shared that 97 percent of hospitals and 75 percent of physicians across the United States are using EHRs. With the vast majority of hospital and physician EHR implementations already complete, it’s clear that EHRs are here to stay.
Despite this popularity, EHR use seems to be contributing to physician burnout and interfering with patient care, according to surveys. For example, 74 percent of 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.
According to a Medscape survey, 57 percent of physicians stated that EHR use reduced face-to-face patient interaction while half said that EHRs limited the number of patients they could see. Echoing this point, a recently published survey from The Annals of Internal Medicine found that physicians are spending half their time in their offices with EHR input while just 27 percent of time is spent directly with patients. Once home, doctors average an extra one to two hours completing or updating EHRs.
As EHR use exacerbates 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 more than half (55 percent) of health IT workers are stressed with 38 percent citing high or extremely high stress.
While these findings may be discouraging, healthcare organizations can prevent provider burnout while improving clinical workflow efficiency and job satisfaction by optimizing their EHR and other clinical IT systems. Through a careful assessment of IT systems and processes, organizations can identify and quantify the daily challenges their providers are facing and then design strategic solutions to allow them to more naturally deliver high-quality patient care.
Impact on healthcare industry
The burnout that EHRs are contributing to today may also be causing negative repercussions that will likely influence the future of the industry. Here are several examples.
Declining physician pool: A Physicians Foundation survey cited that almost half of physicians plan to cut back hours, retire or take non-clinical jobs due to physician burnout, which may cause a shortage of thousands of physicians who would care for the U.S.’ aging population
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 half recommending different career paths to their children.
New or future physicians: A Journal of the American Medical Association study found that burned-out medical students are more likely to engage in patient care misconduct and endorse unprofessional behavior. 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 can also lead to lower care quality, raising medical error, malpractice risk and patient dissatisfaction, which can end up reducing payment under value-based care reimbursement models.
Turning around EHR-related challenges
Providers are not completely opposed to EHR use and agree that some features do increase satisfaction to combat burnout. Nearly two-thirds (62 percent) of physicians deemed e-prescribing as the most useful EHR feature, while easy review of patient information (57 percent) ranked second highest, according to a survey of more than 15,000 physicians across 25 care specialties. The ability to share patient records and lab results, conduct drug/allergy checks and incorporate clinical lab test results all tied (49 percent) for third in helpful features. The survey also found that more than half of physicians (56 percent) believed that EHR use effectively improved the documentation at their practices. Tellingly, 81 percent plan on keeping their current EHR system.
One of the main stressors from EHRs for both health IT staff and end users is EHR usability. To improve this, 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.
EHR navigation can also be improved through more intuitive user interfaces and templates to support efficient clinical workflows and physicians’ natural thought patterns. Care facilities should align processes with industry best practices for structured-form workflows, and work with vendors for task sequence customizations to fit work habits. Instead of EHR bloat, documentation requirements and actual end-user entry need to align, focusing on standardization and simplification of only the most meaningful data.
Finally, health IT staff must properly train and transition end users to be comfortable with and invested in the EHR system. Engagement among health IT staff and providers cannot be overstated. 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.
Sheri Stoltenberg is the founder and CEO of Stoltenberg Consulting, which helps health systems and hospitals implement, manage, and utilize information and business systems.