The demands doctors face – such as building relationships with patients, weathering emotional trauma and navigating digital tools for productivity –  are piling up faster than ever, often leading to chronic stress conditions. In fact, research has shown that more than 50 percent of US physicians are now experiencing some degree of burnout

The economic effects that ripple out from the growing trend of physician burnout are clear:

  • Physicians are major drivers of revenue in most health systems.
  • Physician productivity is directly correlated to physician satisfaction. 
  • 30 percent of physician turnover is due to burnout, and replacing a physician costs health systems between $500K to $1M.
  • Patient satisfaction and patient retention are directly correlated to physician satisfaction.
  • Patient safety is directly correlated to the degree of physician burnout.

While not all of that burnout is due to the electronic health record (EHR) and its related tasks, it is clear that the EHR is one significant contributor.

So, what can health systems do to improve physician satisfaction and decrease burnout related to the EHR? Research has identified five best practices that can make the most dramatic impact: 

  • Comprehensive EHR Onboarding
  • Ongoing EHR Education and Support
  • Robust Communication
  • Shared Ownership and Governance
  • Clinician Efficiency and EHR Personalization

Below are a few key tips organizations can use to positively impact each of the above best practices.

Comprehensive EHR Onboarding

First and foremost, when it comes to the EHR, starting off on the right foot is critical. This means providing a minimum of six hours of training and direct support in the first month of EHR utilization. This should include a combination of classroom or virtual instruction, online modules and personalization sessions before and after EHR usage. Effective onboarding goes beyond the nuts and bolts of your particular EHR system, putting the focus on how these tools can help the physician thrive as a part of the care team. Along the way, use proficiency tests and metrics to gauge success and future training needs. 

Ongoing EHR Education and Support

Next, EHR education and support must go far beyond a single month of onboarding. Epic recommends at least four hours of training per year, using multiple modalities in shorter, consumable sessions. To make this happen, a dedicated training and support team must be put into place that thoroughly understands physician workflows. Proving at-the-elbow support while on rounds or in the clinic is critical; ongoing EHR education must meet physicians where they work and at the time they need it. A great way to keep training ingrained in the team culture on a regular basis is to introduce it into departmental or other already-established meetings. 

Robust Communication

While education is key, communication about the EHR cannot simply come down from leadership as a mandate. Instead, the training and development EHR usage needs to be an on-going conversation. Not all physicians or care team members will feel comfortable communicating in the same way. Therefore, healthcare organizations must engage in active listening by offering staff multiple channels for speaking up on pains, suggestions and needs. This can include surveys, discussion groups, department meetings and governance. 

Shared Ownership and Governance

In the fight against physician burnout caused in part by the EHR, a healthcare system’s best weapon might just be the physicians themselves! Physician builders (PBs) are key “multi-lingual” ambassadors, meaning they are fluent in both the language of the EHR and their fellow physicians. This gives them an edge in helping to craft the most effective EHR possible. Giving PBs a seat at the table through formal governance with broad physician representation allows these individuals to inform analysts what they would like to see built and upgraded. When the direction comes from a place of deep, personal experience, everyone benefits. 

Clinical Efficiency and EHR Personalization

Finally, it’s time to get personal. Getting to this point with any EHR is a team sport. This means engaging operational leaders and training the entire care team on more efficient workflows. Where appropriate, shift administrative tasks to other team members. Monitor efficiency and identify struggling physicians with the help of nurses, clinic managers and EHR vendor tools. High-impact areas can be identified over time. For example, a health system might focus on chart closure by end of day and EHR usage outside of scheduled hours. Regular personalization sessions must be provided as a part of ongoing training efforts. 

While the EHR may not be the only factor contributing to physician burnout, it’s one area where healthcare leaders can make a positive impact. Learn how Alidade Group’s expertise can guide your team to improved physician satisfaction and reduced turnover by contacting our team today!

About the Author:
Dr. Brian Patty joins Alidade Group as the Chief Medical Informatics Officer. As one of the nation’s first CMIOs, he brings more than 40 years of medical and clinical informatics experience to the team.

 

 

 

Sources:

“The Business Case for Investing in Physician Well-being”
Tait Shanafelt, MD; Joel Goh, PhD; Christine Sinsky,MD  
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2653912

“Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review”
Louise H. Hall, Judith Johnson, Ian Watt, Anastasia Tsipa, Daryl B. O’Connor
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159015

“Burnout Among Health Professionals and Its Effect on Patient Safety”
Audrey Lyndon, PhD
https://psnet.ahrq.gov/perspective/burnout-among-health-professionals-and-its-effect-patient-safety

“Association of the Usability of Electronic Health Records With Cognitive Workload and Performance Levels Among Physicians”
Lukasz M. Mazur, PhD; Prithima R. Mosaly, PhD; Carlton Moore, MD; Lawrence Marks, MD
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2729805

“Physician Burnout: The Hidden Health Care Crisis”
Brian E. Lacy and Johanna L. Chan
https://www.cghjournal.org/article/S1542-3565(17)30790-5/fulltext