Physician/Clinician Burnout & Information Technology

Introductions

46% of physicians report being severely stressed & burned out

• “Perfect storm” of: ­patient volumes, ¯time, ¯autonomy, ­regulatory and payer documentation pressures,
EMRs used to enforce workflows (more clicks, limited keyboard UI, alert fatigue, information overload)
• Burn out leads to: ¯quality of care, ¯safety, ¯patient satisfaction
­malpractice lawsuits, ­physician turnover (¯revenue, ­costs)
• EMRs commonly cited/viewed as one of the biggest contributors to physician burnout

1. Do you feel physician and other clinician burnout is a problem in your institution?
2. What IT-related challenges do you know of that contribute to burnout?
3. What are some strategies you are employing locally to address them?
4. What strategies have worked well? Worked poorly?
5. Any ideas on how to identify IT-related challenges we don’t know of?
6. How much of a priority is burnout at your institution? Is it resourced accordingly?
7. How do IT and Medical and Clinical leadership partner together to tackle burnout in your institution?
8. What do you think EMR vendors should work on?
9. Do you know of, or anticipate, any disruptors that will dramatically help with burnout?
10. Any aspect of this topic that we didn’t discuss yet that would be important to cover?

Examples:
IT-Related Challenge Possible IT Solutions/Ways to Mitigate
Alert fatigue CDS review (turn off low yield alerts, redesign, other options)
Limited keyboard UI, too many clicks Speech recognition, virtual scribes, optimized team workflow
Tap & Go, UI redesign by EMR vendors,
Information overload Integrate external info into EMR, search engine, context intelligence
Too many passwords Adopt sane password policies, integrate applications w/AD
Clunky workflows, logging in and out Roaming VDI sessions, patient context passing
Always on move In room computers, mobile apps, support easy home access
Inefficient with EMR Refresher/advanced training

Bibliography
1. VITAL WorkLife & Cejka, 2015 Physician Stress & Burnout Survey. http://bit.ly/2GCJb9o
2. Miller P. The Medical Profession's Future: A Struggle Between Caring For Patients And Bottom-Line
Pressures. Health Aff (Millwood) 2016; 35:407-10.
3. Shanafelt TD, et al. Relationship Between Clerical Burden and Characteristics of the Electronic Environment
With Physician Burnout and Professional Satisfaction. Mayo Clin Proc. 2016 Jul; 91(7):836-48.
4. Linzer M, et al. Worklife and Wellness in Academic General Internal Medicine: Results from a National
Survey. Journal of general internal medicine 2016.
5. DeVoe, et al. Does career dissatisfaction affect the ability of family physicians to deliver high-quality
patient care? Journal of Family Practice 2002; 51:88-94.
6. Friedberg, et al. Factors Affecting Physician Professional Satisfaction and Their Implications for Patient
Care, Health Systems, and Health Policy. RAND Corporation, 2013.
7. West, CP, et al., Interventions to prevent and reduce physician burnout: a systematic review and meta-
analysis. Lancet, 2016.
8. Schiff, GD and Zucker L, Medical Scribes: Salvation for Primary Care or Workaround for Poor EMR
Usability? J Gen Intern Med, 2016; 31(9): p. 979-81.
9. Bank, AJ, et al., Impact of scribes on patient interaction, productivity, and revenue in a cardiology clinic: a
prospective study. Clinicoecon Outcomes Res, 2013; 5: p. 399-406.
10. Hsiao AL, Scribes in the Era of the EMR, Whitepaper for YNHH, 2018.LinkedIn Article, http://bit.ly/2pjsRlq