Provider Burnout and the EHR Experience

High-Level Insights:

• Rates of burnout are still very high but appear to have plateaued since 2021
• High trust in organization leadership/IT around the EHR is correlated with lower provider burnout
• Reducing the after-hours workload can decrease burnout significantly
• Organizations that implement burnout-prevention programs are seeing real results

Help Us Learn More

New questions recently added to the EHR experience survey aim to glean deeper insight into how organizations can address provider burnout. Please consider including these questions in your organization’s next measurement. Topics include:

• The burnout-prevention measures providers want from their organization
• How often patient messages could be handled by other care team members
• Patient care activities below the provider’s licensure
• How providers define after-hours time

Burnout Has Leveled Out in 2022; Staffing Shortages Rise as a Contributing Factor

In 2018 when the Arch Collaborative first began measuring burnout, 27% of providers reported at least some degree of burnout (i.e., they chose one of the following responses: definitely burning out, symptoms of burnout won’t go away, or completely burned out). Burnout has since increased, with 2021 seeing a large spike in the number of providers who report at least some amount of burnout. However, rates have leveled off in 2022 and are holding steady at 34%. The same trend is true for other, non-provider clinicians (not measured in this study). It should be noted that since 2020 the percent of providers reporting higher levels of burnout has increased slightly—particularly those who report they are definitely burning out (up 3 percentage points). Most measured contributors to burnout have become less prevalent than they were at the start of the COVID-19 pandemic. There are a few exceptions. The percent of providers citing a chaotic work environment as a contributing factor has stayed consistent at 28% pre- and post-pandemic. Staffing shortages—a newly-measured contributor as of 2021—are more frequently reported by all types of clinicians, especially in the last year. In 2022, 40% of surveyed providers said staff shortages contribute to their sense of burnout. As providers report higher degrees of burnout, they are more likely to report a higher number of total burnout contributors.

With Foundation of Trust in Leadership/IT, Less After-Hours EHR Time Tied to 19% Lower Burnout

One key to lessening provider burnout is strong provider agreement that their organization delivers well around the EHR—specifically, that the organization has done a great job of implementing, training on, and supporting the EHR. Higher trust in organization leadership/IT in these areas is tied to providers being less likely (by 16 percentage points) to feel burned out. Even among providers who spend more after-hours time in the EHR—who would be expected to have higher rates of burnout—trust in leadership/IT around the EHR is correlated with lower burnout. Providers who chart six or more hours a week but have trust in their leadership/IT experience burnout rates lower than the Collaborative average. Providers who both trust their leadership/IT and chart after-hours for less than five hours per week have an average burnout rate 19 percentage points lower than other providers.

Learn from Your Peers

The following organizations have successfully improved their clinicians’ EHR experience through specific, targeted efforts. To learn more, read their case studies linked below.

UW Health and AQuity partnered to reduce after-hours documentation for providers by implementing virtual scribes. 88% of providers who participated felt this program reduced the time they needed to spend on after-hours documentation. Providers also were less likely to report feeling burned out.

Legacy Health created the Super Thrive program, a three-day off-site training that has helped increase trust between clinicians and their organization. Following the program, clinicians reported higher trust in the organization leadership/IT (up 38%) and lower rates of burnout (down 7%).

Community Health Network built a provider informatics team to help support providers in their efforts to personalize the EHR. Similarly, Rush Health created a team of physician EHR builders to bridge the gap between providers and IT professionals and build a culture of cooperation. Both efforts highlight the importance of strengthening relationships between providers and their organization.

Timely and Well Communicated EHR Fixes Strongly Correlated with Lower Provider Burnout

At times, providers can view IT as a black hole, and this dynamic reduces interactions and collaboration between the two groups. However, providers who feel they are supported in their EHR by organizational IT teams report lower levels of burnout. One of the most telling indicators is whether EHR fixes are made in a timely manner. In general, providers who agree with this statement and report trust in IT have an average burnout rate 16 percentage points lower than their peers (see second chart below). Additionally, communication around EHR changes is important; providers who agree changes are well communicated have a burnout rate 11 percentage points lower than those who disagree. When IT and support personnel are more transparent—for example, they update providers regarding requested changes—providers feel more supported and empowered around the EHR experience and their overall experience in the organization. This transparency is also tied to lower burnout.

Learn from Your Peers

The following organizations have successfully improved their clinicians’ EHR experience through specific, targeted efforts. To learn more, read their case studies linked below.

Southern Illinois Healthcare (SIH) improved their EHR support by developing and updating governance committees. These groups helped foster transparency between providers and IT. Providers were taught how to make and track EHR change requests. This facilitated requests being made in a timely manner and made providers feel they had a voice in EHR changes. The ticketing system also allowed requests to be more easily submitted.

Dayton Children’s Hospital prioritized transparency to the benefit of providers by defining how resources related to EHR optimization are allocated. They did this by strengthening their IT governance model and developing committees whose job is to assist providers with their EHR concerns.

Burnout-Prevention Programs Are Making a Positive Impact

Healthcare organizations have successfully improved their clinicians’ experience at work by implementing programs specific to reducing burnout. Many organizations who participate in the Arch Collaborative have asked their clinicians about participation in a burnout-prevention program and whether the program was helpful. KLAS recommends that all organizations implement one or more of the programs measured in the chart below, since all have significant potential to alleviate provider burnout.

Insights from Successful Organizations on Combatting Burnout

To learn more about these organizations’ efforts, read their case studies linked below.

Ozarks Makes a United Decision on a New EHR—Trust in the Organization Increases, Burnout Levels Decrease

Ozarks Medical Center (Ozarks) improved provider trust in the organization leadership/IT around the EHR by involving a unified group of providers from across the organization in the decision to switch EHRs. Over 200 clinicians participated in the process. They were separated into 20 different groups to determine which EHR would best suit them. These clinicians were almost unanimous in their decision for a go-forward EHR. Upon implementation of the EHR, Ozarks also required that all clinicians receive a minimum of six hours of EHR training prior to the go-live. Following the change in EHR, provider agreement that the organization delivers well around the EHR improved by 34%, and the overall rate of provider burnout decreased by 10%. Ozarks Medical Center shared that their approach to deciding on the EHR helped unify the organization and strengthened trust in leadership. This in turn made providers more excited about working at the organization and resulted in reduced feelings of burnout.

Yuma Credits Lower Burnout to Availability of Continual At-the-Elbow EHR Support and Peer-Based Support

Yuma Regional Medical Center credits their providers’ low burnout rates to the EHR onboarding process and ongoing support—this includes at-the-elbow support from IT technicians and providers’ peers. Yuma has a larger-than-average number of provider leadership positions for an organization of their size (for example, they have 27 staff medical directors), and this means more physicians have the opportunity to lead among their peers. It also results in a more simplified process for providers to reach out to someone when they have questions or concerns about the EHR. This has resulted in reduced feelings of burnout. Traditionally, there is a knowledge gap between IT technicians and providers, so Yuma leverages certified, trained physicians who work with EHR analysts and help design the EHR. This ultimately helps bridge that gap for both sides. One large pain point for Yuma providers was getting patients through care encounters on time because of EHR issues. By implementing a point of contact that providers can speak to after a patient visit, the atmosphere of visits has improved for providers and patients. In the organization’s most recent EHR experience measurement, 19% of their providers reported feeling burned out, which is 14 percentage points lower than the current Arch Collaborative average.

Recommendations for Decreasing Provider Burnout

Build trust in organization leadership/IT—put structures in place that give providers a voice in the EHR, facilitate quick responses to enhancement requests, and ensure the EHR is continually being improved. Engage providers in decision-making processes.

Decrease after-hours workload. One helpful approach can be the use of scribes for clinical documentation. Some organizations also benefit from “sprint” events that facilitate an intensive environment where providers can learn skills or implement interventions to reduce after-hours charting.

Implement programs designed to alleviate provider burnout. Peer-mentoring programs can be particularly effective at improving the provider experience, including reducing burnout rates.

What is the Arch Collaborative?

What is the Arch Collaborative?

The Arch Collaborative is a group of healthcare organizations committed to improving the EHR experience through standardized surveys and benchmarking. To date, over 250 healthcare organizations have surveyed their end users and over 240,000 clinicians have responded. Impact reports such as this one seek to synthesize the feedback from these clinicians into actionable insights that organizations can use to revolutionize patient care by unlocking the potential of the EHR. To participate in the Arch Collaborative, go to https://engage.klasresearch.com/klas-arch-collaborative/.