Clinician Burnout: EHR Usability May Be the Culprit

Key Learnings:

  • Clinician burnout is a top priority for healthcare organizations 
  • EHR usability is strongly tied to clinician burnout
  • Several factors impact usability and there are industry improvement recommendations

Clinician burnout is an increasingly imperative condition to address for healthcare organizations. As the COVID-19 pandemic continues to put pressure on staff, supporting care providers’ wellbeing is essential. However, burnout was an issue before the pandemic, and has been impacting both clinical and organizational outcomes for years.

Organizations have spent budget on dedicated lounges, exercise programs, reimbursements for wellness visits and more – but are these methods hitting the mark? They may have some benefit and are surely appreciated gestures, but they don’t address one of the biggest drives of clinician burnout – the EHR.

Inherent in the work of care providers and unavoidable, EHRs are here to stay – but the burnout they sometimes drive can be suppressed by focusing on usability.

According to a survey of more than 5,000 physician EHR users, today’s EHR’s received a failing letter grade for usability, and study of the survey results found that the “F” grade was largely associated with clinician burnout.

A comprehensive clinician burnout strategy must include EHR usability to yield results, and below are a few strategies to consider.

Strategies to Improve EHR Usability & Reduce Clinician Burnout

1. Limit Disruptive Alerts

Ease of navigation is one of the largest factors contributing to clinician burnout. Cluttered interfaces, complex medication lists, and constant pop-ups and alerts can easily contribute to cognitive overload, fatigue and medical errors.

To address this, organizations may be able to configure the EHR to display different visual alerts instead of the traditional disruptive notifications, and nudge differing care providers to tackle certain tasks.

For example, as described in EHRIntelligence, Beth Israel Deaconess Medical “set up an EHR visual aid that placed a simple red highlight around the checkbox of the order, alerting the clinician to a duplicative or incorrect test order.” This small adjustment resulted in a 49% reduction in unintentional duplicative orders for lab tests and a 40% decrease in unintentional duplicative orders for radiology tests. It also naturally reduced the amount of disruptions clinicians encountered while navigating the EHR, helping to reduce clinician burnout.

Another tactic reviewed in a JAMA study was using the EHR to nudge medical assistants, rather than physicians, to set up and order overdue preventive screenings. Utilizing these nudges resulted in increased screening orders and time savings for physicians – allowing them to spend more time in patient care which reduces burnout.

2. Utilize Voice-Enabled Documentation Technology

Documentation is a leading driver of EHR-induced clinician burnout. Converting manual notes into the EHR takes a tremendous amount of time, and physical shadow scribes have their limitations.

EHR voice-enabled add-ons allow providers to dictate their notes directly into the EHR, and even transcribe entire patient visits. They eliminate the need for physical notetaking and enable providers to spend more time in patient care and less time in tool-based tasks.

AWS announced such a tool in December 2019 and, as described by Jacob Geers, Solutions Strategist for Cerner Corporation, “Extreme accuracy in clinical documentation is critical to workflows and overall caregiver satisfaction. By leveraging Amazon Transcribe Medical’s transcription API, Cerner is in initial development of a digital voice scribe that automatically listens to clinician-patient interactions and unobtrusively captures the dialogue in text form. From there, our solution will intelligently translate the concepts for entry into the codified component in the Cerner EHR system.”

 

3. Continue Training After Deployment

Most healthcare organizations go through extensive trainings when an EHR is deployed. However, as EHRs implement new features and make updates, trainings rarely continue. Ensuring staff is aware of and adapts well to new EHR functionality is essential to reducing clinician burnout.

According to researchers of a 2019 study from the KLAS Arch Collaborative, “If health care organizations offered higher-quality educational opportunities for their care providers — and if providers were expected to develop greater mastery of EHR functionality — many of the current EHR challenges would be ameliorated.”

In fact, researchers found 475 cases in which physicians of the same specialty utilized the same EHR system and had drastically different user experiences, largely driven by differences in training.

Researchers said, “In over 89 percent of these instances, the physician who strongly agreed also reported better training, more training efforts, or more effort expended in setting up EHR personalization.”

Improving EHR usability is inherent in curbing clinician burnout out. Begin with an assessment of your EHR default settings and interface customization opportunities to begin relieving the pressure.


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