New Trends in Clinician Burden

Over the past year, Allscripts conducted research about the causes of and concerns about clinician burden as well as solutions to help combat it. We asked Ross Teague to discuss his learnings based on a recent series of interviews with C-level executives from organizations of varying sizes, each using different EHR vendors.
 

RT: Almost universally, the belief surrounding clinician burden is that it is spawned from many factors, and that the majority of causes are external and out of clinicians' control. There are concerns about how documentation and regulatory requirements affect clinicians and it's fairly common to hear the comment that most of what's required doesn't have direct impact on patient care. We heard frequently that clinicians believe too much of their data entry serves a downstream purpose and not their own. What surprised me most was, as we conducted more and more interviews, we learned that social media has increased the burden on clinicians and has become a cause for many clinicians leaving healthcare. We believe this is because so much emphasis is put on patient satisfaction and many clinicians feel that focus often conflicts with best clinical practice. We heard stories about nurses leaving jobs at hospitals after being negatively portrayed on Twitter because of something that happened outside of their control.
 

RT: The most commonly mentioned concerns are about the impact clinician burden has on data integrity, turnover and safety. But across the board, something came up that we don’t often hear discussed: how burden has a strong, negative effect on clinician engagement. Clinicians who are experiencing burden are less likely to participate in organization-sponsored programs, including: mentoring younger clinicians, attending safety councils, reviewing health IT products and participating in programs focused on reducing burden. Most organizations report that their entire organization is burdened as they “try to do more with less resources.” Nurses were often discussed by community hospital interviewees, and we learned that nurse burden is as much of an issue as physician burden. CMIOs believed nurse burden may have increased recently because organizations are trying to reduce physician burden, which then adds more to nurses’ workloads without eliminating any persisting tasks.
 

RT: While most organizations can point to how they have begun reducing burden, many of the members of C-level hospital leadership we talked to feel they have a lot of work to do. Most of the successes come from prioritizing issues and highlighting distinct successes so clinicians can see (and experience) the progress firsthand. One organization said it has seen great success in defining and publicizing what sources of burden the organization can control, while pointing out which sources of burden it cannot. This has led to people in the organization feeling less hopeless while not blaming the organization for everything that burdens them. Most of the organizations that have a collaborative relationship with their health IT vendors notice better results than those that don’t. Organizations that emphasize training and a more formalized roll out of new functionality have shown to reduce burden.
 

RT: Healthcare is extremely complex, and the tools we offer providers need to be designed with this complexity in mind. Organizations need health IT products that offer more flexibility and align with the intricacies of the domain. Technology shouldn’t force clinicians to change how they interact with and listen to patients; it must support best clinical practices. Organizations are asking for more user-friendly and intuitive products, but the most common demand is for products to take a more active role in helping clinicians meet their goals of delivering better care and helping patients achieve better outcomes. Clinicians want to feel supported by technology to feel confident about making the right decisions and being able to strike a better work-life balance.
 

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