Monday, December 25, 2017
Clicking Your Way to Burnout
The Mayo Clinic published the article Electronic medical practice environment can lead to physician burnout that “shows the use of electronic health records and computerized physician order entry leads to lower physician satisfaction and higher rates of professional burnout.”
The negative effects of decreased efficiency, massive clerical burden, and provider burnout counterbalance the positive potential for quality medical care using an Electronic Health Record. These negative forces seem obvious to any practicing provider but are generally lost on administrators, insurance companies, vendors, and governmental agencies.
Logical reasoning would indicate, however, that when providers, including nurses, are “happy,” productivity, motivation, and commitment are increased, leading to higher quality and greater safety in health care.
The authors conclude that: "Burnout has been shown to erode quality of care, increase risk of medical errors, and lead physicians to reduce clinical work hours, suggesting that the net effect of these electronic tools on quality of care for the U.S. health care system is less clear."
What is the solution? Some have been mentioned multiple times in previous blogs. But here is a list of EHR functionalities that have great potential to impact quality of care:
1. User-friendly, site specific, specialty specific documentation
2. Easy navigation with intuitive, user-friendly interfaces 99.9% consistent every day, every site.
3. Changes, should be made gradually, to avoid having to relearn the program every outing
4. Uniform CPOE (computerized physician order entry) that is the same in every system
5. Institution of a national database to encourage real-time interoperability
6. Voice activated technology built-in
7. Bringing back the “Ward Clerk” – that is, let the doc do doctoring, the nurse nursing.
8. Decreasing the work burden-eliminate unnecessary machine time, as well as homework
9. “Alert” controls. Too many alerts are ineffective, become “white-noise.”
10. Ability to see what other people are documenting without making lots of clicks
11. Every click should be counted to help design a better interface, with minimized clicks.
12. Keep clinical interaction IT separate from bookkeeping and billing IT.
13. Artificial intelligence that provides an “instant second opinion.”
Hopefully, the future will brighter. Bean-counters should remember that clicks have financial and psychological costs. And the wrong click could cost thousands of beans.