From the Consultant’s Corner 10/12/17

Addressing Physician Burnout – It’s Not Just the EHR

Physician burnout continues to rise in all specialty areas. Fifty-five percent of family medicine and internal medicine physicians who participated in the 2017 Medscape Lifestyle Report reported burnout. Fifty-nine percent of emergency medicine and 56 percent of all Ob/Gyn participants reported burnout. While EHRs are often credited as a major contributing factor to physician burnout, a deeper analysis of the root causes of physician burnout is necessary in order to address this challenge.

Administrative burdens placed on providers have accelerated with a variety of regulatory requirements including MU, ICD-10, and now MACRA. Population health management, value-based reimbursement, and coding scrutiny will continue to influence clinical workflow design and EHR usage. A poorly developed or executed EHR implementation approach will absolutely magnify these challenges. Practice leadership should engage their physician community to separate those EHR-related issues, which can be improved upon through optimization initiatives, from the administrative burdens that require alternative solutions in order to have a meaningful impact.

Up until the past two years, our EHR optimization engagements primarily focused on client goals of improving physician productivity. Increasingly, a common driver of most recent engagements is to reduce or eliminate the time physicians spend on administrative, non-clinical tasks, which contribute to physician burnout. These client administrators recognize the administrative burdens placed on their physicians, and they are keenly astute to the costs and disruptions of recruiting and onboarding new physicians. It is simply more cost effective to address physician burnout proactively, than to replace them.

I recommend several tactics below for provider organizations to start the process of addressing physician burnout. There is no silver bullet, but engaging physicians and making real, sustainable efforts to improve their satisfaction will have meaningful impacts.

1. Inefficient workflows and poor EHR design/navigation are far too common. Unfortunately, many vendors accentuate this problem by well-intended yet unproven “best practice” workflow recommendations. Engage your clinicians to understand the bottlenecks and redundancies of their current workflows. Clinical workflow optimization comprised of using all clinical resources to the maximum level of their licensure is a good first step.

2. EHR personalization, focused on enhancing clinical documentation, order entry, results management, and messaging is another best practice. Additional benefits of EHR optimization include enhanced revenue integrity and reduced charge lag, which accelerate cash collections.

3. Provide continual training opportunities for physicians and nurses to introduce and reinforce advanced tools that accelerate clinical documentation.

4. The use of scribes is not a new concept; however, it is a relatively high-cost solution for shifting the administrative tasks off a physician’s plate. Several models of virtual scribes have started to gain traction and are worthy of consideration as an additional tactic to ease burnout for your most at-risk providers. There are different flavors of these services, each with different value propositions and cost considerations. By offloading most of the EHR data entry to a virtual scribe, more face time is spent with the patient and encounters are closed (and billed) at the completion of the patient visit.

Brad Boyd is president of Culbert Healthcare Solutions in Woburn, MA.

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