By David Lareau
After more than a year, we are finally seeing light at the end of the COVID-19 tunnel. Rather than constant worry about infection, testing, and vaccines, the health care world will soon have bandwidth to consider some of the other pressing concerns that have been largely ignored in recent months.
One of the top priorities for healthcare leaders will likely be addressing escalating rates of clinician burnout, which now strongly impacts the lives of 47% of physicians, according to the Medscape National Physician Burnout & Suicide Report 2021. Among the more than 12,000 physicians participating in the survey, over 70% felt that burnout had at least a moderate impact on their lives, and 79% believe that burnout has been growing for years.
Though many factors contribute to burnout, a study published in the Journal of Medical Internet Research found that 75% of clinician respondents who “reported burnout symptoms identified the EHR as a contributor. Lower satisfaction and higher frustration with the EHRs were significantly associated with perceptions of EHR contributing toward burnout.”
EHR has long been blamed for fueling clinician burnout and creating a destructive cycle of clinical depression, depersonalization, inadequate care, low patient satisfaction, negative feedback, and unprofessional behaviors. In addition to driving higher levels of physician attrition, burnout increases clinical errors and patient safety risks.
Making EHRs more usable for clinicians is an imperative for healthcare decision makers seeking to address the problem of clinician burnout. As stakeholders move forward with initiatives to maximize the efficiencies of their current EHRs, these four areas should be key targets.
Enhancing clinician productivity
Making EHRs more friendly and efficient for clinicians starts with streamlining workflows to deliver users easy access to the information they need, when they need it. This limits the amount of wasted time spent sifting through charts to find relevant information and frees clinicians to focus on patient care. Additional tools that automatically collect relevant details to support billing and coding functions can further enhance clinician productivity
EHRs also need technologies that support the automatic identification and interpretation of all the disorganized and complex arrays of medical information from previous encounters, lab reports, inpatient records, and other sources. Clinicians spend less time searching through computer screens because they are automatically served pertinent information for effective decision making. For example, when users have one-click access to a problem-oriented view of specific conditions, such as diabetes or high blood pressure, clinicians can take immediate action, which improves productivity.
Clinician productivity is further enhanced when the computer does not disrupt how clinicians think and work. “Enhancements” that are designed to make clinical decisions on behalf of physicians can make EHRs less useable because they interfere with clinical workflows and rarely tell a physician what he or she does not already know. To preserve productivity, clinical workflows should replicate – not replace – the way physicians deliver care.
Delivering high-quality patient care
EHRs were never designed to meet the needs of clinicians, much less support the delivery of better patient care. EHRs were instead developed to help billers and coders get the patient, diagnostic and treatment information required to perform their jobs. Unfortunately, clinicians have been delegated burnout-inducing data entry tasks that serve the needs of financial teams, take away from patient care, and drive job dissatisfaction and burnout.
Instead of acting as barrier to the delivery of quality care, clinicians need technology that enhances their ability to care for patients – which means healthcare leaders must liberate clinicians from the drudgery of data entry and allow them to focus on patients. Rather than act as data entry clerks, clinicians need technologies that work behind the scenes to capture and interpret the billing and coding details from clinical documentation. In addition, clinicians require workflows that deliver comprehensive and filtered views of relevant patient- and problem-specific data at the point of care to support the delivery of high-quality patient care.
Making it easier for clinicians to quickly access critical patient information reduces physician frustration and burnout and enhances patient safety.
Driving accurate reimbursement
Organizations participating in Medicare Advantage and other risk-bearing reimbursement programs require accurate documentation to support coding and reporting requirements and drive accurate reimbursement. Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores, for example, are used to estimate patient care expenses and calculate provider reimbursement.
To satisfy payer requirements and drive accurate reimbursement, providers traditionally rely on retrospective, manual chart reviews to uncover possible documentation and coding gaps. When gaps are identified, patients are often asked to make a follow-up visit – which is clearly inconvenient for both the patient and clinician.
A more efficient option is for the EHR to work in the background to verify billing, coding, compliance, and quality measurement and ensure the right information is captured in the documentation for accurate reimbursement. This minimizes data entry requirements and the need for error-prone manual search methods. It also supports clinician workflows, making it easy for physicians to fully and accurately capture a patient’s status for all qualifying diagnoses during the encounter.
Reining in operational expenses
Streamlined clinical and documentation workflows create greater efficiencies, providing healthcare organizations the opportunity to rein in operating expenses. For example, transcription needs can be reduced or eliminated if clinicians have documentation tools that support the quick and efficient capture of visit information at the point of care.
Technologies that automate manual processes can further reduce operational expenses – and the likelihood of manual error – by increasing the efficiency and accuracy of clinical documentation, coding, and billing. Organizations can also reduce operational expenses with the addition of technologies that support value-based care programs and facilitate access to high-quality data for queries and reporting.
As the world moves beyond the current health crisis, healthcare leaders must consider ways to improve clinician satisfaction and reduce burnout. By focusing on EHR changes in these four core areas, organizations can make their systems more usable for clinicians and improve the quality of patient care.
David Lareau is the chief executive officer of Medicomp Systems, which provides physician-driven, point-of-care solutions that fix EHRs.