Insights Into the EHR and Physician Burnout

Physicians bear many burdens. Their bodies are often taxed as they move through long hours of work, and their minds are pushed to the limit as they constantly focus at high levels and give great attention to details. This Sisyphean effort is compounded by the requirement to document and validate all that work in the EHR. Most of us are aware that at least some physician stress stems from the EHR itself.

The stress resulting in physician burnout is not just some abstract concept. In fact, the International Classification of Diseases (ICD-11) recognizes burnout as a definitive medical diagnosis (QD85). But there are many things organizations can do to recognize and relieve the issue. Let’s review what KLAS has learned about reducing frustration with the EHR to improve clinician wellness.

Perhaps the most important factor to consider is the framing of the issue. It is easy to just say, “I want to avoid physician burnout at my organization.” Some physicians we have spoken with prefer to see the issue as an opportunity to make positive changes in an organization and not just to avoid negative ones. One physician commented, “I would like to see a focus on wellness, fulfillment, or thriving rather than just on whether clinicians are burned out or not. A workforce that is simply not burned out is not the goal; that is the minimum.”

So, what can be done with the EHR to promote physician wellness and satisfaction?

Determine Where Your Organization Is

Arch Collaborative and other KLAS data around EHR satisfaction suggest a Maslow-type hierarchy of needs when it comes to EHR systems. There are certain fundamental issues that must be solved before higher-order issues can be addressed for meaningful, positive impact. Consider these four questions to illuminate any issues at the basic level:

1. Is the EHR available when you need it? E.g. does the system experience almost no downtime?
2. Does the EHR have the fast system response time you expect?
3. Does the EHR provide expected integration within your organization?
4. Does the EHR provide expected integration with outside organizations?

The majority of organizations have addressed the basic issues highlighted by these questions. However, an Arch Collaborative Impact Report highlights that, while stable, functioning software is foundational to success, spending time in training and assisting clinician end users renders the best results in improving EHR satisfaction. So let’s examine the next questions, which focus on clinician interaction with the EHR.

1. Does the EHR have the functionality for your specific specialty or clinical care focus?
2. Does the EHR provide the analytics, quality measures, and reporting you need?
3. Is the EHR easy to learn?
4. Does the EHR make you as efficient as possible?

These issues are where your organization can establish physician satisfaction with the EHR. This is also the phase where we find most of the industry to be focused. Accordingly, Arch Collaborative insights offer two ways that help to measurably increase satisfaction.

Training and Personalization

Physicians became experts in their field by spending years of their lives dedicated to medical pursuits. They have already demonstrated their exceptional intelligence and incredible work ethic. So why does it seem like they are so hung up by a piece of software? Our data suggests that it is because they need more than a few scant hours during onboarding to learn how to best use the system.

Organizations that implement regular, continual training programs for all staff members can increase user satisfaction in the system. As the professionals at your organization are granted more hours to add to their EHR knowledge base, their demonstrated ability to learn effectively can take hold and make them masters of the software meant to help them do their work effectively and safely.

EHRs can also be tailored to meet the precise needs of a physician’s workflow and work style. Taking time in the training schedule for individual physicians to set up personalized workflows will drastically improve satisfaction with the EHR. Every physician in your organization can take advantage of setting up workflows to match the way that they think and process problems. This is where the EHR no longer becomes an obstacle to the work but a companion to it.

Moving from Satisfaction to Thriving

At its best, the EHR should be a system that actively promotes patient wellness and aids the physicians who provide care without impeding them. And I think there will be a time when the EHR will reverse its role as a perpetrator of dissatisfaction and redeem itself as a tool of physician wellness. Believe it or not, there are organizations right now where physicians can positively answer these three final questions:

1. Does the EHR enable you to deliver high-quality care?
2. Does the EHR keep your patients safe?
3. Does the EHR allow you to deliver patient-centered care?

Getting to this level is hard. It requires both the organization leaders and the physicians putting in the time to learn how to master the EHR and use it to provide the best possible care for patients. The problems that arise along the way can test every aspect of an organization. But the result is worth the effort. Physicians who can feel like physicians at work, not like slaves to clunky software, are physicians who not only avoid burnout but also achieve fulfillment in the workplace.

KLAS is dedicated to helping provider organizations measure how they are doing with EHR satisfaction and finding ways to improve through the Arch Collaborative. If you are not already a member, consider joining. We would love to share more insights with you and help your organization improve your users’ EHR satisfaction.

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