Written by: Cheryl Reifsnyder, PhD
In the past few years, burnout has become an ever-increasing issue among healthcare providers, and physicians have not escaped its effects. A study published in the Mayo Clinic Proceedings reported that nearly 63% of physicians had at least 1 sign of burnout in 2021, compared with 38% in 2020—the highest burnout rating in a decade of survey findings. The study also found that physicians’ satisfaction with work-life integration dropped during this period, from 46% in 2020 to 30% in 2021, as well as their professional fulfillment scores, from 40% to 22%. About 35% of physicians experiencing burnout reported that those feelings increased significantly in 2022. A separate Medical Group Management Association (MGMA) poll found that 40% of practices surveyed had had a physician resign or retire early due to burnout within the past year.
Clearly, physician burnout is a multifaceted problem with no simple solution—but we have an important question for you to consider: Is it possible that your electronic health record (EHR) system might be contributing to physician burnout at your practice?
The International Organization for Standardization defines usability as “the extent to which a product can be used by specified users to achieve specific goals with effectiveness, efficiency, and satisfaction in a specified context of use”. Providers use EHRs to perform everyday clinical tasks, but also to manage workflows and participate in federal incentive programs, such as Meaningful Use. It’s vital that a tool with so many functions is intuitive, navigable, and easy to use.
However, it’s a near-constant complaint that EHR technology impedes physicians’ relationships with patients. Data entry tasks associated with EHR systems cut significantly into the time available for engaging patients, leaving only half of a physician’s day for direct clinical interactions. Physicians describe EHRs as a distracting and depersonalizing element during patient visits.
Physicians also describe EHRs as unintuitive and inefficient, detracting from clinical focus, and sometimes even leading to patient harm. EHR activities are consuming valuable provider time, requiring too many clicks to report and access key patient information. Overall, EHR usability is unacceptable to most U.S. physicians.
The 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act provided $27 billion in federal incentives to encourage adoption of EHRs, with the intention of improving health care quality, outcomes, and efficiency. It led to large-scale adoption of EHRs throughout U.S. healthcare practices—but during this period of increasing EHR use, the nation has seen a notable increase in physician professional dissatisfaction and burnout. This has led many to speculate that the increased administrative burden EHRs place on physicians is a key factor in the escalating burnout levels.
Researchers found that the number of hours physicians spent daily on EHRs contributed to increased feelings of work-life imbalance and professional dissatisfaction, as well as high rates of attrition and burnout rates greater than 50%. More recently, researchers evaluated the relationship between burnout and physician-perceived EHR usability. They found that EHRs’ mean usability, measured using the System Usability Scale (SUS, a standardized metric of technology usability) was 45.9 +/- 21.9; a score of 45.9 ranks in the bottom 9% of scores and is categorized in the “not acceptable” range—a failing, or “F,” grade.
They also found that physician-rated EHR usability was strongly associated with odds of physician burnout, with each 1 point more favorable SUS score associated with 3% lower odds of burnout.
In another study, published in the Journal of the American Medical Informatics Association (JAMIA), authors undertook a systematic review of factors contributing to EHR-related effects on physician well-being—and found that perceived EHR usability was one of the top predictors of clinician burnout.
One of the primary ways to improve EHR usability is to increase its efficiency, making changes that enable providers to enter information with fewer clicks. Poorly designed EHRs have physicians suffering from the growing sense that they are neglecting their patients as they try to keep up with the seemingly never-ending stream of type-and-click tasks and increased clicks are associated with increased burnout.
Veradigm EHR (VEHR) and its suite of configurable ambulatory solutions help improve EHR efficiency by streamlining workflows, assisting with the clinical intake and management process, and providing back-end solutions that help remove administrative burdens to free up valuable provider time. Our goal is to make our EHR as efficient as possible.
One way we improve EHR efficiency is by decreasing required data entry. For instance, one of VEHR’s key features is the availability of visit templates to allow easy documentation of patient encounters. Visit templates enable providers:
Our solutions also incorporate artificial intelligence (AI) to improve efficiency. AI algorithms identify physicians’ most common diagnoses and treatment plans to reduce the number of clicks required in a given encounter.
Smart lists are another VEHR key feature for improving provider efficiency. Smart lists identify trends in providers’ and practices’ order habits to provide a list of items most frequently ordered for specific diagnoses. A “short list” (like bookmarks in a web browser) is created using pattern recognition to match workflows and typical treatment scenarios, which can then lead to personal smart list recommendations for each provider.
VEHR also increases provider efficiency by integrating Prescription Management into the workflow to make prescribing quicker and easier. This helps to get therapies into patients’ hands more quickly. VEHR provides integration with state-controlled substance registries and Prescription Drug Monitoring Programs (PDMPs).
Continuing education on EHR features and updates is perhaps just as important as EHR solution design. When meeting with users, we often find that clients aren’t aware of key features that could save them significant time. User group conferences provide opportunities to network with other users as well as Veradigm representatives, enabling users to learn shortcuts and get questions answered.
Answering questions does not need to wait for the next conference, though. Realizing that continuing education is crucial for providers wishing to optimize their EHR usage, we provide iLearn: a knowledge base of short, 60 to 90-second videos that can be accessed any time, from any location with an internet connection. These videos provide tips, tricks, and easy ways to keep up with system features and updates. By spending a few minutes a week on iLearn, providers can ensure they are taking advantage of the solution features they are already paying for.
If our EHR can provide a better user experience, then physicians can get back to putting their patients first.
An EHR’s usability is clearly correlated with physician burnout rates—which is why it’s so important to work with a vendor who makes EHR usability a high priority. But usability is shaped by more than just EHR design—it’s also shaped by the quality of the EHR’s implementation, configuration, customization, documentation, and, perhaps most importantly, the quality of the vendor’s interactions with users.
That’s why, at Veradigm, we meet with client user groups and listen to their suggestions, and why we have a physician advisory board. That’s why we prioritize working with and listening to our users—to learn your specific needs and better understand the challenges you face in the field. Our goal at Veradigm is always to make our solutions as efficient and effective as possible, and we depend on our users to help us determine the best way to do that.
To learn more, or to schedule your VEHR demo, contact us today.