Physician Burnout: The Whole Digital Picture

In my work inthe Arch Collaborative, I recently ran across a physician comment that changed my perspective on physician burnout. This comment established the EMR as just one of the digital solutions that physicians use every day. The physician said, “I don't really have a problem with the EMR. I'm pretty good at it, and the reason I don't finish my notes in the clinic is the rigmarole involved in billing and required documentation. I don't hate the EMR. The problem I have is computer-based burnout, which the EMR is a big part of. The problem is the whole electronic world of email and so forth. I spend all day every day on the computer. And it is mentally exhausting.”

How much time does a physician spend in other digital environments (now ever present with the rise of ubiquitous smartphones), texting, emailing, tweeting, and so on? And how much will this increase as we connect the patient more tightly with the physician?

Let’s all agree that while the EMR is not going away, it can be improved as a tool to support care delivery. How much of an EMR’s clinical capabilities are being used effectively? How many clinical functions are included in initial EMR training or follow-up EMR education?

If we establish effective use of EMR-personalization tools for extracting the data physicians need to provider higher-quality and more timely care, and if we also help them to navigate the EMR more effectively, can we make EMR use more efficient?

I also believe we must stop inferring that the EMRs are only designed for billing and outcomes reporting and are not designed to support care delivery. All major EMR vendors have physicians on staff to help design the clinical applications. Clinical applications can be tailored to address the workflow needs of specialists as well.

I have been told that the RAPs (radiologists, anesthesiologists, and pathologists) will never be happy. But Arch Collaborative research demonstrates that EMR workflows can be established based on the workflows of specialists who have high EMR satisfaction.

But let’s move to the next level. As we add secure messaging and encrypted emails for sharing patient information or communicating directly with patients, how are we implementing these applications to ensure intuitive and efficient use by the physicians?

Where do these applications fit within the workflows of the physicians to improve care-delivery efficiency? Can these applications be effectively integrated into the EMR to reduce digital exhaustion? Or has the integration of these applications with the EMR increased physicians’ digital frustration?

Perhaps we need to establish a digital governance committee to ensure we have a complete picture of what is impacting physician burnout. This type of committee could start by evaluating all the digital devices and applications physicians are using every day.

This should include non-patient digital applications that physicians use as well. Once we have established a picture of physicians’ complete digital environment, we can start to develop approaches for reducing physician burnout that are not just EMR focused.