Want to Address Clinician Burnout and Administrative Burden? Fix the EHR First

Brian Silverstein, MD
Tue 28 Mar 2023
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Health systems, ACOs, and CINs looking to alleviate their labor shortages and sustainably reduce clinician burnout should consider the right technology to automate tasks and processes, minimizing data entry and creating space for cognitive work. This can improve productivity, increase retention and have a positive impact on care quality, patient capacity, and revenue.

Administrative workloads have heavily affected the performance of physicians and medical staff in delivering patient care. While many blame the pandemic for the intensified clinician burnout and healthcare’s labor shortage, more factors contribute to the challenge. According to a study from the National Library of Medicine, doctors spend approximately 17% of their working hours on administrative work, which depletes career satisfaction and increases physician burnout rates.

A Kaiser Family Foundation survey found that about 30% of healthcare workers are considering leaving their jobs. In addition, 60% of those surveyed stated that stress due to the pandemic had harmed their mental health. Already struggling to fill clinical roles before COVID-19, many over-stressed hospitals are approaching a breaking point. 

We’re witnessing an increased urgency to liberate healthcare professionals from the strain of tedious and repetitive tasks so they can focus on what drew them to medicine in the first place: caring for patients.Battling issues like staffing shortages and burnout are not easy to navigate. However, available solutions can ease provider workloads and allow care managers to work smarter, not harder. For instance, outsourcing a team of Virtual Care Navigators (VCNs) to handle chronic care management (CCM) or transitional care management (TCM) can prove highly beneficial because both workflows usually require a considerable number of resources

While there are measures in place, they’re not entirely successful as they do not address one of the fundamental drivers of clinician dissatisfaction and frustration—the EHR system. In other words, COVID did not cause clinician burnout; it accelerated it. EHRs are a significant and addressable source of burnout and administrative burden afflicting clinicians today

Here’s a two-birds-with-one-stone solution: By radically improving the cumbersome EHR, the healthcare industry would significantly free up clinician time AND enhance care coordination, patient engagement, and health outcomes. 

What will that take? A step beyond the traditional approaches to EHR—an EHR platform that complements EHRs and significantly improves the way clinicians interface with them. 

How Can We Reduce the Administrative Workload for Clinicians?

Workplace technology is meant to improve processes and lift productivity. Yet, in the case of EHRs, the time clinicians now spend on data entry has not significantly improved compared with the time they spent on paperwork before the EHR era. Imagine if we were to make a typical process more efficient by equipping care coordinators with workflows allowing them to devote most of their time to patients while engaging them effectively

Consider the typical primary care visit. The patient is forced to repeat the same information in an endless loop. Meanwhile, the clinician devotes precious time and attention to data entry with little payoff in terms of insights derived from the patient record, lab tests, images, other interventions, or evidence-based best practices

Eliminating the data gathering and scheduling process will reduce the administrative burden for care teams and nursing staff and facilitate greater patient participation. An ideal workflow keeps the maximum time window for tasks technology cannot help—i.e., genuine person-to-person patient care. Technology that assists care coordinators by eliminating administrative tasks creates time for tying together the broken pieces of patient-focused care delivery. 

Challenges Created by Bad Workflows

  1. Heavy Time Investment in Follow-Ups: Much of a care team member’s time is spent in front of computer screens, creating reminders or confirming events/appointments, creating lists of patients, and sending individual messages to patients.
  1. Poor Patient Engagement: Low patient engagement leads to a high rate of patient no-shows. Communication gaps with patients from different geographies also lead to low adherence to appointments and medication
  1. Care Team Burnout: Administrative tasks like daily calls and follow-ups with patients are extremely time-consuming and inefficient. Long screen hours can exhaust care coordinators, leaving them with little energy to interact and engage with patients
  1. Low Patient Satisfaction: Poorly engaged patients feel uninvolved in their care, leading to low retention and satisfaction. Patients do not feel empowered to make informed health decisions and end up paying higher care costs due to low medication adherence or missing preventative examinations
  1. Poor Health Outcomes: Poorly designed workflows leading to low patient engagement are linked to poor health outcomes. As a result of low adherence, patients stop actively participating in their care journeys, which leads to high costs and inferior health outcomes. 

EHRs and the Road Ahead

EHRs were a necessary first step in healthcare’s digital transformation. The shift from paper records and faxes to zeroes and ones is foundational to better patient care and population health. However, healthcare’s transaction-focused, EHR-driven system is clunky and ill-suited for the needs of clinicians and patients. 

An entire patchwork sector has arisen to implement costly but incremental improvements to EHRs. While they help remove pop-ups, reduce alerts, transcribe or automate entry, bring machine intelligence to searches, and speed up processes, they are only an assortment of bandages and will not replace or transform the EHR system itself

Optimizing EHRs is insufficient, but getting rid of EHRs is not the answer, either. Despite their limitations, EHRs have aggregated massive quantities of patient and clinical claims data. It’s time to advance them further by overlaying the core transaction engine with portals, dashboards, and sophisticated data, analytics, and automation capabilities. 

Healthtech to the Rescue

The fundamental problem with EHRs is that they were built to tally care utilization and process billing, not improve information entry, workflow, care coordination, health outcomes, and patient engagement. With nurses, care teams, and providers caring for hundreds of patients, it’s impossible to analyze the data for each patient. Due to a lack of the right technology, care coordinators miss out on essential information about their patient's health status, discharge, and medical history, or fail to retrieve information on time. 

The right technology platform empowers care teams and gives them the autonomy to search and retrieve real-time insights into a patient’s health story at various milestones. With these insights, providers and care teams can apply the right interventions to get better health outcomes with customized, patient-centric care plans

A healthcare data and analytics platform can achieve this with solutions that

  1. Streamline Workflows: Empower care coordinators with workflows that tell them the daily patient flow and only ask for their input when needed. It automates end-to-end follow-ups and supervision schedules for all the patients in a network. 
  1. Automate Follow-Ups: The solution sends and schedules thousands of automated outreach campaigns. It also empowers patients with contextual information about their health and optimized clinical visits through messaging campaigns
  1. Limits Screen Time: Care team members can spend less time on their screens, as most non-direct care tasks are automated
  1. Provides Robust End-to-End Engagement: The solution looks after the patient’s health journey across the continuum of care. Data-driven and automated at each stage, it has triaging capabilities that fully engage patients with their risk scores
  1. Close Care Gaps: Care teams and patients are provided to-do lists, medical history, lab reports, upcoming appointments, messages sent in the past, and many other relevant details to ensure there are no gaps in care

With a data platform and solutions that automate workflows, limits screen time, frees up providers’ time to engage with patients, and seamlessly integrates with EHR systems, clinicians can have power at their fingertips to support patients in achieving the best health outcomes. For the provider organization, that expanded clinician capacity effectively addresses the labor shortage challenge while reducing burnout by improving morale, engagement, and clinician performance. 

That’s the kind of productivity technology should offer: for organizations, greater efficiency, and happier associates; for clinicians, less stress, less burnout, less time with tech, and more time with patients and their human needs. 


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Tags: Physician Burnout
Brian Silverstein, MD
CPHO, Innovaccer

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