Industry Voices—It's time to light a fire to stop physician burnout, starting with better EHRs

Doctor computer medical records
Dissatisfaction with electronic health records is helping fuel physician burnout. (Getty/BrianAJackson)

While there’s some dispute as to which direction the trend line is pointing, the undisputed fact is nearly half of all practicing physicians report feeling burned out.

The psychological phenomenon of “burnout” is known to be a catalyst for depression, alcohol and drug abuse, and in extreme cases, even suicide. (Experts estimate that between 300 and 400 physicians in the U.S. take their lives every year—the highest rate of any profession, and nearly double that of the general population.)

In itself, this is an enormously troubling statistic. It also is part of a larger challenge confronting the U.S. healthcare system: an impending shortage of about 120,000 physicians by the year 2030, according to the Association of American Medical Colleges. The potential consequences of such a shortage are profound.

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When physicians are taken out of rotation, bandwidth issues quickly begin to surface. Understaffed programs make everyone’s workload that much heavier, exacerbating the effects of burnout for the physicians who remain.

It’s one of the most dangerous types of domino effects and, along with electronic health record (EHR) dissatisfaction, is one of the biggest drivers of today’s physician burnout epidemic.

A recent investigation by Fortune and Kaiser Health News addresses the serious (even life-threatening) consequences associated with poor EHR usability. EHRs were supposed to reduce, if not eliminate, the significant amount of paperwork for which physicians were responsible. Unfortunately, that didn’t happen; the “paperwork” just moved to a computer screen and continued to expand.

Today, 44% of the roughly six hours a physician spends on EHRs each day is focused on administrative tasks. That work can be surprisingly stressful—researchers note that physicians’ heart rates spike as high as 160 beats per minute while using EHRs.

The bottom line is EHRs aren’t supporting doctors the way they were intended to, and are diverting valuable time that could be spent with patients.

Ironically, before the EHR, a physician’s biggest pain point was not having access to enough data. Patient information was siloed, typically in dusty paper charts buried in the basement or out of reach in off-site storage. Physicians didn’t have a comprehensive view of the patient.

Now with EHRs, providers should have better access to patient information. Alas, that often is not the case, as vital information is buried in a sea of redundant or irrelevant data within electronic clinical notes.

It is crucial the healthcare industry empowers physicians with tools that will make them better.

Unfortunately, forcing physicians to wait their turn for one of too-few hospital workstations is not making them better. Sending physicians dozens of alerts that question every step in their decision-making process is not making them better. Asking physicians numerous irrelevant questions related to every patient update is not making them better. And forcing physicians to use a standard, one-size-fits-all computer interface is not making them better.

As problematic as EHRs have been, implementing a well-designed, clinician-facing information technology environment is possible. Mobile platforms, which afford ready and actionable access to relevant patient data, can accelerate care. Simplified computerized physician order entry or CPOE functionality and streamlined documentation workflows boost efficiency and increase physician time at the bedside.

Advances in artificial intelligence, data visualization and modern interface design present opportunities to dramatically improve the usability and clinical value of information technology.

To be sure, physician burnout won’t completely disappear just by optimizing EHRs for providers. Other contributing factors also must be addressed. However, EHR optimization is an important step for healthcare organizations to take as part of a concerted effort to address physicians’ needs. The future of the U.S. healthcare system depends on it.

Christopher Maiona, M.D., is chief medical officer of PatientKeeper, Inc.

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