Overcoming Technical Inefficiencies to Enhance Provider Well-Being

The configuration of the electronic health record (EHR) has been attributed as a leading cause of burnout by imposing preventable, time-intensive documentation tasks, and lengthy chart reviews upon providers. Historically, however, the toll these administrative, bureaucratic, and documentation demands have taken on providers have been overlooked, contributing to burnout rates jumping from 42% pre-COVID-19 pandemic to 65% for some specialties in 2023.¹

This has resulted in clinicians leaving their jobs or finding opportunities outside of the hospital, costing organizations upwards of at least $7,600 per employed physician per year due to turnover and reduced clinical hours.²

For the clinicians that remain, these demands tend to interrupt the patient-provider relationship by placing focus on satisfying documentation "requirements" instead of patient care. Half of physician days are being spent on computer charting and desk work, with more than a third of their time with patients being spent on non-clinical tasks – resulting in lower patient satisfaction scores.^3,4 Additionally, physicians are spending an average of nearly 10 hours a week to complete documentation after work hours. As a result, burnout further intensifies for providers.⁵

Nine Areas of Technical Inefficiency

When seasoned providers, IT leaders, or analysts enter an instance of an EHR, such as Epic, they can quickly gauge whether it represents “inefficiency” or “best practice.” For example, telltale signs of an under-optimized instance of Epic include lengthy build request turnaround times, siloed record build, cumbersome provider access processes, and numerous meetings with limited progress.

These tiresome and time-intensive processes often translate into nine areas of technical inefficiencies that fuel the fires of provider burnout:

1. Lack of provider involvement in EHR governance
2. Clinical documentation strains
3. Problem list maintenance
4. Message and alert overload
5. Underuse of personal health information apps, such as MyChart
6. Orders mismanagement
7. Inefficient ED workflows
8. Lab order and result complexities
9. Repetitive manual processes

While many organizations have multiple areas of inefficiencies embedded in the daily workflows of providers due to ineffective EHR builds, there are paths forward to lower technical workflow burdens and significantly reduce EHR burnout. Leading organizations are identifying these pain points and applying seasoned, best-practice fixes for long-term sustainability at a fraction of what provider turnover and burnout is costing them.

From Burnout to Best Practice

Clinical care is the tip of the burnout iceberg. In addition to administrative and documentation burdens, clinicians are overloaded with tasks involved in direct patient care, regulatory/legal requirements, hospital and professional billing, and engaging with patients and families. Technical inefficiencies increase the cognitive load – the mental effort required to process and retain information – on clinicians. By understanding and addressing issues with optimized EHR enablement, leaders can significantly improve clinician well-being.

We suggest a two-pronged approach to restoring your EHR from a state of inefficiency to best practice. These enhancements do not require hefty investments in third-party software; instead, targeted adjustments, streamlined workflows, and effective collaboration can lead to significant improvements that will aid in reducing provider burnout while applying lasting benefits for your organization.

Fix EHR workflows. Your organization’s EHR instance needs to be corrected using certified builders with advanced build skills and operational proficiency to make impactful changes. You’ll need experts who can guide you through the process of reducing provider burnout by improving EHR governance and ED workflow efficiency, streamlining clinical documentation and problem lists, simplifying message, alert, and ordering processes, modernizing lab orders and results, automating manual processes, and expanding the use of personal health information apps like MyChart.

For example, introducing and operationalizing under-leveraged EHR capabilities can play a major role in alleviating the symptoms of burnout. EHR tools are designed to create efficiencies, improve workflows, and generate an overall uptick in clinician satisfaction. Leveraging improved data visualization, rules-based automation, and standard AI tools and predictive models within Epic, for example, can help to address inefficient workflows and redundant tasks.

Invest in EHR education. According to KLAS Research, inadequate training is one of the top contributors to burnout.⁶  Not only do providers need to learn the system so they can navigate it efficiently, they also must be trained on the latest updates to adopt them successfully. Without effective EHR education, users develop workarounds that drain time, energy, and mental capacity. Investments in EHR design, governance, and training yield the most satisfied users.

Continuous training is critical to EHR feature adoption and enablement. Organizations need shared EHR education tools and processes and 1:1 support to ensure all users are up to date on the latest functionality relative to their needs. For example, learn how clinicians spend their days and focus training on how their time will be used to complete requirements within the EHR. Additionally, ensure your training teams are embedded and visible to users outside of scheduled trainings, as a united front. It’s essential that training teams and training materials are as integrated as their ideal EHR workflows.

EHR Optimization Solutions

While EHR burnout is a common issue across organizations, one size does not fit all for the solution. Customized solutions help health systems maximize their EHR investment by infusing leading practices into native tools while lessening the cognitive burden on clinicians to alleviate burnout. By optimizing their EHRs, health systems can enhance provider satisfaction, quality, patient care, and the bottom line.

Co-authored by Hannah Ellerbee, Ariella Nathanson, and Carole McCarthy, BSN, RN

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¹https://www.medscape.com/slideshow/2023-lifestyle-burnout-6016058?faf=1#2
²https://www.acpjournals.org/doi/10.7326/m18-1422
³https://www.aha.org/news/headline/2016-09-08-study-physicians-spend-nearly-twice-much-time-ehrdesk-work-patients
⁴https://www.aha.org/news/headline/2016-09-08-study-physicians-spend-nearly-twice-much-time-ehrdesk-work-patients
⁵https://www.aha.org/news/headline/2016-09-08-study-physicians-spend-nearly-twice-much-time-ehrdesk-work-patients
⁶https://klasresearch.com/archcollaborative/report/provider-burnout-and-the-ehr-experience/454