Healthcare News & Insights

Why EHRs aggravate physician burnout and need to fundamentally change

Physician burnout’s a big issue in health care. And one of the leading contributors to burnout is electronic health records. In this guest post, Caesar Djavaherian, MD, co-founder of a modern, tech-enabled healthcare provider designed to put patient-care first, explains how to lower burnout rates through technology.

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Today, one of the leading concerns for physicians is: How are we going to solve our high burnout problem? For years, medical studies and reports have called physician burnout a state of “crisis,” and the issue has become widely-recognized and discussed in medical circles. With physicians experiencing burnout rates 10% higher than in other professions, it’s imperative to dig deeper into the problem in the search of a transformative solution.

What are the top reasons driving burnout?

According to the research paper Physician Burnout: Causes, Consequences, and Cures, two major concerns are:

  • “Dissatisfaction among physicians with how their time and skills are used is widespread and growing.”
  • “The highly trained U.S. physician … has become a data-entry clerk, required to document not only diagnoses, physician orders, and patient visit notes but also an increasing amount of low-value administrative data.”

In fact, electronic health records (EHRs) are cited as one of the leading contributors to physician burnout and a deep dissatisfaction for how their time is spent. As a result, we need to start by probing into why EHRs are so widely problematic for the physicians who use them – and consider what can be done to alleviate the frustration and inefficiency they so often cause.

In 2001, the Institute of Medicine published a report entitled Crossing the Quality Chasm:  A New Health System for the 21st Century, which stated that, “Between the health care we have and the care we could have lies not just a gap, but a chasm.”

This realization of the chasm between the technology we did have and the technology we could and should have led to a race to see who could develop an EHR that would help physicians deliver the most up-to-date healthcare to their patients, using the most up-to-date technology.

Currently there are more than 1,100 EHR products available, and the use of EHRs is approaching 100% among medical practices and hospital systems across the U.S. But as the implementation of EHRs has rapidly increased since 2001, so has the rate of physician burnout – not despite widely-available healthcare technology, but precisely because of it.

As Atul Gawande so famously pointed out in his article in The New Yorker entitled, Why Doctors Hate Their Computers, the EHRs so many hospital systems have implemented come with a steeper cost than the software’s multi-million dollar price tag. These EHRs also cost healthcare providers time, mental and emotional energy, decreased work satisfaction, increased burnout and – perhaps most alarmingly – rates of depression and suicide that are 50% higher than the general population.

BandAid fixes

In the meantime, instead of addressing the larger issue at hand, many medical institutions are trying to use perks to soften the administrative burden. Some hospital systems have gone so far as to offer free dry cleaning, childcare, meal delivery services, housekeeping and handyman services to offset EHR-induced stress. The truth is that these measures are only a small, temporary, ineffective and unsustainable attempt to mask a glaring problem. In other words, they are a BandAid fix that can never come close to addressing the potentially-fatal wounds that EHRs cause the physicians who are forced to use them.

It’s time to acknowledge that BandAid fixes are no longer acceptable. We need more than superficial solutions. We need to solve the root issues at a fundamental level.

Some healthcare companies have begun to imagine what’s possible if we stop searching for BandAid fixes for poorly-designed EHRs and instead begin to transform health technology at a fundamental level.

EHR design flaws are much like mutated DNA. When flaws persist at the micro level, they become macro-level issues that cause the larger problems seen since EHRs became widely adopted – especially physician burnout.

In giving ourselves permission to imagine what health technology could and should be, we’ve realized that EHRs should adapt to each practice’s needs. Instead of demanding that practices adapt their workflows to meet the requirements of an unwieldy, one-size-fits-all EHR, we’ve been able to create health technology that’s efficient, intuitive and physician-friendly.

For example, using iPads instead of desktop or laptop computers allows for better eye contact between providers and their patients. iPads also allow providers to move through notes more quickly with an efficient touch-screen rather than wasting time on the myriad mouse clicks most other EHRs use. Providers can log in using facial recognition software instead of spending time entering log-ins and passwords. And the use of responsive, intelligent software suggests templates, diagnoses and ICD-10 codes based on keywords captured from the patient’s chief complaint.

Among providers using iPads and this type of software, job satisfaction and retention is on the rise. Providers who used to spend an average of two hours finishing charts and completing tasks after each shift are now spending less than 30 minutes.

Changing technology at a fundamental level is the most strategic way to lower burnout rates in a significant, sustainable way. It increases provider satisfaction, ultimately improving patient care and closing the chasm between the ineffective medical technology many physicians currently use and the intuitive, smart, streamlined medical technology they should and could be using.

Dr. Caesar Djavaherian is the co-founder of CarbonHealth and founded DirectUrgentCare.

 

 

 

 

 

 

 

 

 

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