Most hospitals around the country have implemented, and started using EHR systems. It is evident that this technology is here to stay. With the use of EHRs, physicians have less paper work, less administrative costs and ideally offer quality care to patients. If EHRs are effective, they benefit patients as well since they reduce cases of medical errors.
While EHRs have plenty of benefits to both the patients and the physicians, they can cause plenty of frustration among medical professionals and physicians. It negatively affects physician satisfaction and productivity. Although EHRs are here to stay, they can contribute to physician burnout and interfere with general patient care.
A study done by Mayo Clinic Proceedings found that the increasingly electronic nature of modern medicine is strongly linked to physician burnout.
A survey published by The Annals of Internal Medicine show that most physicians spend 49.2% of their time on EHRs while only 27% of their time is spent treating patients.
For most physicians, work does not end in the office, they have to spend about two hours updating and completing the EHRs at home. The survey also showed that physicians do not like the electronic part of their work because it causes distractions in the examination room causing them to shift focus from the patient.
Consequences of Physician Burnout
Physician burnout can be described as a public health crisis especially with the substantial increase over the last couple of years. The consequences are significant and affect the healthcare system by affecting the quality of care, health care costs and patient safety.
- Health Care Costs: Physician burnout affects costs both directly and indirectly. It affect costs directly through early retirement of physicians, high staff turnover and working less than full time. The cost of replacing a retired physician include recruitment, training and even revenue lost during this period that adds up to thousands of dollars. Physicians who look past the signs of burnout and keep working offer low quality and less safe care to their patients. It affects costs indirectly through unnecessary testing and referrals, greater risk of malpractice and medication errors among others.
- Patient Dissatisfaction: As the levels of physician burnout hit an all-time high, so does the patient dissatisfaction levels. Physicians are encouraged to embrace multitasking push past the burnout. Patients end up feeling secondary and generally dissatisfied with the services rendered to them. In medical care, patients are primary and should always come first.
- Effect of EHR Physician Burnout: The negative effects of EHR burnout are not only going to be felt today but also in the future. It could negatively influence the future of the healthcare industry in a number of ways. Below are some of the repercussions of EHR burnout in the future.
- Decline in the Pool of Physicians: Many physicians do plan to retire early, shift to non-clinical work or cut their working hours because of the burnout. This action by top physician could lead to a shortage of physician in the long term. A shortage in the number of physicians could be a crisis given the increase in the population of the aged.
- Future Physicians: Medical students experiencing burnout are more likely to engage in unprofessional behavior and in-patient misconduct. This means that patients get poor quality services.
- Lower Care Quality: Physician burnout is directly related to the increasing cases of medical error and patient dissatisfaction. Patient dissatisfaction is attributed to beeing treated as secondary while they should be at the center of medical care.
Role of EHR Usability in Physician Burnout
Understanding the role played by EHR in physician burnout is the first step in developing counter measures. Below are four ways in which EHR drives burnout and how to remedy each of the problems.
- Work overload: Performing tasks on the EHR takes at least two times longer to complete when compared to working with paper charts. Previously, physicians could just scribble down their notes or dictate them quickly to a transcriptionist and be done within a short time. They now have to type their notes or use speech recognition software, which slows them down. Filling in a prescription used to take just 5 seconds, but with the EHR it takes anywhere between 20 and 200 seconds.
- Remedy: Work overload can easily be remedied by using team care, scribes and many others. Physicians need a leadership team that is supportive. The leadership team should give them expertise, time and the financial support needed to develop these
- Lack of control: The physicians have no control of the user interface or how they are supposed to enter a patient’s data. Alerts usually pop up when they are not needed and this adds to the complexity of the system. They might intend well, but they do not add to the quality of care given to patients.
- Remedy: Lack of control can easily be mitigated by having the physicians partnering with the EHR technical staff so they can redesign the user interfaces. They should also work together so as to develop guidance tools for alerts that are more appropriate. This will make a big difference to the physicians
- Insufficient Rewards: Physician sacrifice a huge chunk of their lives getting the training they need to competently and confidently practice medicine. The reward they expect is working with many patients and getting to see them actually get better. With EHRs, physicians treat half the patients they did without EHRs. With the strain brought about by EHRs the joy of practicing medicine gets eroded.
- Remedy: Physicians and clinic leaders should partner to redesign the workflow so as to foster stronger connections with the patients.
- Breakdown of the community: In the past, if a physician needed to consult a colleague on a case, he would call him or her and inquire about it. However, today one just has to enter a referral order in the system rather than discuss the issue. Doctors and nurses spend less and less time talking to each other. They however spend more time seated side by side each one interacting with a machine and not talking to each other.
- Remedy: This can be remedied by working as a team in the ward and calling to discuss a case. Administration should also support different ways for the physicians to come together whether during lunch break or after hours.
Physicians around the country have within a short period of time adopted EHR technology in their practices. However, the EHR technology just meets the minimum features so as to conform to the prescribed regulatory standards. It is safe to say that this alone contributes to the frustration experienced by many physicians and possible physician burnout.
Most EHR vendors have offered digital tools that are really just physical world analogs. Vendor focus has been on digitization and not on fundamental improvement. It is fortunate that health technology is still in the early days of rolling out.
If every vendor took the time to listen to each user’s needs, they would drastically improve EHR usability and in turn improve the physician satisfaction levels. It is time to make the necessary changes to the EHR system so as to redirect focus from the screens and back to the patients.