Is healthcare IT causing a clinician burnout epidemic?

Stress

It used to be so easy as a Marcus Welby-era general practitioner or nurse when the most sophisticated technology was the blood pressure cuff. Record keeping was a matter of manila folders with cryptic paper notes and prescription records filed in giant buff-colored cabinets. There was a library of patient x-ray records with a lightbox where they could be read with some degree of detail.

And then high technology came and complicated things beyond belief.

The traditional school of thought would be that healthcare practitioners have a high burnout rate because of the nature of the business. Other than the birth of a baby, there are very few “blessed events” in the day of the life of the healthcare professional.

Of course, the incredible increase in cures has dramatically changed the ability to provide good news to patients and their families. But the fact is, the profession typically starts with bad news and strives for a positive outcome. The worst kept secret is that technology has become the backbone of high quality patient engagement and care.

While healthcare vendors, researchers and pundits will rightfully tell us that technology actually increases the quality of professional life for those in a clinical setting, the process of getting to that point is littered with techno-burnout victims.

Technology: A double-edged sword

Surprisingly, only a part of the burnout comes directly from the day-to-day anguish of seeing sick adults or children. Technology itself has added pressure unlike any other time in history. One could argue that much of this pressure is actually “legislated” in the form of government mandates like Obamacare and other value-based care mandates.

What was previously a rather generous system of experimenting, with a variety of treatments, has now been met with much greater scrutiny for accountability leading to reimbursement. Anyone who has needed an MRI on their knee over the past few years knows that the orders are not issued and approved as they were in the old days.

Anyone on the front line of patient-facing healthcare will tell you that the documentation aspects of the business are mind boggling. It all started with the ICD-10 coding system that included 16,000 (later expanded to 68,000 with subsets) classifications for various ailments, diagnoses and procedures that were required on electronic health records and reimbursement forms.

In a recent study commissioned by Vocera and conducted by HIMSS Analytics, it was reported that 44% of clinical leaders felt that technology (such as electronic health records) was a key cause of clinician burnout.

The transformation to this coding system brought on the first wave of burnout among physicians who in many cases could not rely on their assistants to decrypt their notes (or dictation) in order to select the precise diagnosis on the new systems. In many healthcare systems, nurses were not permitted to code for the physicians, so the doctors needed to allocate more hours to paperwork at the expense of patient care. Many who moved from private practices to large healthcare collaboratives were especially prone to technology stress as a result of the demands of the larger enterprises.

Nurses are even more prone to technology-related burnout given their traditional roll in the documentation process. Add to this decreased staffing and longer hours that increase the volume of record-keeping required and one can see why technology can be both a cause of and a solution to mental health issues.

Antidote: IT-clinician collaboration 

On the brighter side, what the HIMSS Analytics research did show was that 76% of clinical leaders felt that “fostering greater collaboration between clinical and IT teams to ensure technology actually improves workflow” was a key factor in reducing stress.

This circles back to the initial premise of enterprise IT getting to know the business at the patient-engagement level. Those organizations bringing what might not normally seem to be “the normal suspects” (nurses and doctors) into the product evaluation and purchase process could see very positive employee health and satisfaction implications, not to mention the improved continuum of care effect on patients as a result.

RELATED LINKS

Clinical and IT collaboration drive value-based care

Introducing the born-digital hospital

Should our devices know when we’re stressed?

 

Comments

  1. Lynn Christofferson says:

    Add academics to the IT mix and incorporate medical coding and medical data analytics curriculum at the secondary school level (computer science, internships, apprenticeships) and at a more advanced, pre-med level.

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