Restoring the art of practicing medicine: Reducing physician burnout with streamlined clinical communication

There are numerous surveys demonstrating that electronic health records (EHRs) are taking a toll on physicians.

One of the most recent and large-scale surveys of nearly 6,400 physician participants showed EHRs have contributed to a lower career satisfaction rate and increase the risk of burnout.

Bottom line: We clinicians are increasingly feeling less like clinicians and more like data- entry clerks.

Regardless, digitization of healthcare information is vital to improving the process and outcomes of healthcare delivery. And it’s not only EHRs. Burnout is also caused by inefficient communication workflows (pagers and faxes), needless phone tag and disconnected team collaboration. There isn't much we can do about EHR-related burnout as we are likely stuck with them as-is for the foreseeable future. Poor communication and inefficient care team coordination however, can be reduced if not completely eliminated. A truly integrated clinical communication and workflow platform allows anyone within the circle of patient care to take rapid and effective action on this data just as we do in our private lives using our mobile smartphones, tablets and computers.

Exceeding physicians’ “pain” threshold
The fact that physicians in the Mayo Clinic and other recent surveys complain about dissatisfaction and burnout caused by EHRs is notable on several levels, but the most immediate is because it’s just surprising. Physicians, in general, have high psychological “pain” tolerances. I’m not implying that other careers aren’t highly stressful, but the education and training followed by an unpredictable and often grueling work schedule, conditions us to tolerate physical, psychological and cognitive stress at higher levels than many other professions.

The introduction of EHRs has seemed to push many of us beyond our tolerable “pain” threshold. EHR-driven computerized physician order entry (CPOE) and other data entry, however, is only part of the toil that contributes to burnout. Time for patient care, as well as one of the more meaningful, but lesser discussed, aspects of our profession—collegial collaboration—is disappearing in part due to EHR demands which drive physicians down a path of having to enter seemingly endless and often repetitive data.

Science vs. art
Medicine is undoubtedly grounded in science, but few would argue that the practice of medicine is an art. Many clinical decisions are not black or white, but rather grey. Often, particularly on complex cases, there is a great deal of collaborative decision making on what is optimal treatment for a particular disease or situation. Depending on the case, numerous consultant physicians both inside and outside the organization can be called in for their evaluation and recommendations. With so many of us burdened with data entry and copious documentation, the time to digest and evaluate this vital input from other clinicians around an event can disappear rapidly. EHR data entry has become the focus instead of efficient collaboration around the patient.

Without a unified form of communication workflow focused on a single patient, these collaborations become much more difficult, if not impossible, and delivering top-quality care becomes even harder. It is time for most healthcare systems to abandon antiquated clinical communication methods such as pagers, faxes, walkie-talkies and answering services. The simple uncertainty as to whether information, a call or a page was ever received, or what action should be taken, should not be a part of today’s medicine or allowed to contribute to the larger problem of physician burnout.

Supporting efficient clinical workflows
Radically changing EHR user interfaces to make them more efficient and less time consuming for physicians is largely outside the control of most hospitals and health systems, nor does it appear that it will happen any time soon. These organizations can greatly improve physician workflow efficiency and morale by introducing tools that release them from EHR-driven or old-fashioned communication methods.

Smartphones, for example, have had strong penetration since we founded our company in 2010 among physicians and nurses, who were using text messaging to transmit or get patient information. Today, at least 81 percent of physicians use smartphones in their practice, according to a 2016 survey.

Secure text messages alone are just the beginning. Mobile technology has the potential to alleviate so much of the EHR or communication-driven toil that physicians, nurses and other care provider’s experience. Another example is the ability to easily create team-based conversations around a single patient, including all the physicians, nurses, role-based functions, labs, digital imaging, transport and other clinical support staff needed to provide the most seamless delivery of care. Engaging and updating the entire care team in real-time means every aspect of that patient’s treatment is sped up and given greater context to inform clinicians’ decisions and actions.

Ensuring all relevant team members are included in these group discussions is essential, but it can also be frustrating due to healthcare organizations’ continual shift changes and on-call schedules. With a unified, mobile clinical communication platform that allows physicians and other clinicians to search for each other by their role alone, such as the on-call orthopedic surgeon, needing know a colleague’s name or their phone number is not required. That physician can then be notified and respond directly and securely through a smartphone, eliminating tedious extra steps that are required with an answering service, pager or voicemail. Just this very basic aspect of simply finding the right person, delivering the precise information needed, receiving an answer, and acting on it in a timely manner is a huge advancement in healthcare. Those steps today can take hours or more, but with a properly configured clinical communication and workflow platform, that time can be reduced to a few minutes.

Returning the joy to practice
Why has taken this long for healthcare to finally start embracing the notion that these incredibly handheld powerful computers can improve healthcare delivery? I don’t have the answer, but a unified, mobile clinical communication platform, which spans across all things digital in healthcare, is a massive leap forward and would deliver a major boost to burned-out, time-starved clinicians.

We have the best technical ability to provide the greatest healthcare in the world, but we also have a broken communication process. The ability to fix that issue is now at hand and we could very quickly see a radical shift in improving patient care and a return to the joy of practicing medicine.

About the author:
Will O’Connor, M.D., serves as Chief Medical Information Officer of TigerConnect.


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