Provider burnout was a big problem long before the pandemic — costing the United States healthcare sector at least $4.6 billion a year. Intense schedules for providers; lack of time off and long, unsafe shifts; burdensome administrative duties; the ongoing provider shortage — the Association of American Medical Colleges projects that the U.S. will face a shortage of between 54,100 and 139,000 physicians by 2033 — all played a part in this growing crisis. Then came COVID-19 and all of its variants adding even more pressure to the intense burden providers already shoulder.
There are a lot of factors that play into provider burnout — health technology, however, has definitely — albeit fairly — held the lion’s share of the blame. One study looking at HIT-related stress reported the main outcome as self-reported burnout. Specifically, of the 1,792 physician respondents, 26% reported burnout. Among EHR users (91%), 70% reported HIT-related stress, with the highest prevalence in primary care–oriented specialties. We know that health IT impacts burnout; however, now technology can also be a formidable ally to reduce some of the triggers contributing to burnout in our sector, so how can we flip the script by looking at ways for it to help? Let’s take a deeper dive into four issues fueling provider burnout and how technology can help.
COVID-19 severely exacerbated the strain on our healthcare workers and healthcare organizations. The AMA surveyed 20,947 physicians and other workers across 42 healthcare organizations across the U.S. during the pandemic to assess their stress levels and found that 61% felt high fear of exposing themselves or their families to COVID-19 while 38% self-reported experiencing anxiety or depression. Another 43% suffered from work overload, and 49% had burnout. There have been hurdles throughout the pandemic beginning with a lack of PPE for healthcare workers, to staff falling ill with COVID-19, to ICUs being overrun with sick patients, putting extra pressure on overtaxed workers. The virus surges, variants, and messy vaccine rollouts haven’t helped.
There is a silver lining here, though. While COVID-19 was extremely harmful, it did also force a rapid evolution of telehealth and, with it, benefits for providers. Telemedicine lived up to its hype during the pandemic and continues to thrive. Telemedicine allowed practices to keep their doors “open” and continue to see patients who needed care when it was unsafe to do so in person. Physician’s Weekly reported that telemedicine can help offset provider burnout (when reimbursed adequately) by leading to fewer missed appointments and can allow providers to work more efficiently; enabling providers to provide more dedicated, consistent care; and increasing patient access to care resulting in better outcomes.
Telemedicine affords flexibility that isn’t always seen in the practice of medicine. Modio Health Founder and CEO, Dr. Kirk Heath, says about telemedicine, “COVID-19 has shown us that in many instances, we can perform at an optimal level while remote. In my experience, I’m often able to see more patients, and the quality of the connections I form with them is higher when I don’t have to shuffle them around in an office. Aside from the bonds I’m able to create with my patients, I’m also more productive without the distractions of sitting in an office.”
Providers have been vocal about how much of their time is spent on administrative tasks in addition to their clinical duties. The American Medical Association (AMA) reported on a study incorporating data from more than 20,000 physicians across nearly 30 specialties and found that nearly a third of physicians said they spend 20 hours or more a week on paperwork and administrative tasks; 70% of physicians surveyed said they spend more than 10 hours a week on paperwork and administrative tasks. In 2018, Medical Economics asked physicians in a poll, “What’s ruining medicine for physicians?” Paperwork and administrative burdens topped the list.
Dr. Heath wrote about the high volume of administrative tasks increasingly consuming physician time for KevinMD, specifically as it relates to provider credentialing. “Provider credentialing, which is one of the most important and necessary processes in healthcare to ensure patient safety , is stuck deep in the Dark Ages,” says Heath. “We see every day that healthcare is rapidly embracing innovation and technology, yet physician credentialing is one of those strange, still-on-paper workflows.”
What can we do to eliminate administrative waste in healthcare? It’s critical that healthcare organizations embrace technology innovations that will reduce or remove the burden of unnecessary administrative tasks. Take provider credentialing, for example, which is still often done manually, i.e., Post-it notes on filing cabinets and Excel spreadsheets. Credentialing physicians is extremely complex and time-consuming, yet modernizing the credentialing process makes it profoundly easier for talented, fully credentialed physicians to more seamlessly see patients whenever and wherever care is needed and in a way that’s most convenient for both patient and provider. Modio has already done this with a cloud-based credentialing technology platform where real-time primary-sourced data can be centralized and automated, making provider verification across multiple states easier, quicker, more accurate, and more secure. Investing in and training the right administrative staff can reap benefits for the long-term as well.
There have been many studies showing that EHR technology has played a big role in physician burnout. “Too many physicians have experienced the demoralizing effects of cumbersome EHRs that interfere with providing first-rate medical care to patients,” said AMA President Patrice A. Harris, MD, MA.
EHRs are not the sole culprit of technology’s misfire in healthcare. Too often innovations are brought to the market without the end-user adequately factored into the equation or even consulted in the development process. Dr. Harris says, “It is a national imperative to overhaul the design and use of EHRs and reframe the technology to focus primarily on its most critical function — helping physicians care for their patients.” This holds true for health IT in general.
Health technologies can be more thoughtfully designed and implemented, allowing them to remove burden from the provider rather than add to it. Chief nursing information officer, Cambridge University Hospitals NHS Foundation Trust, Helen Balsdon, said: “Technology has great potential, but you need to get the human element right. Technology needs to add value and make a positive impact to what we do and how we do it, for it to achieve sustained adoption.”
Provider burnout is becoming more widely recognized; however, support is still greatly lacking. The New York Times reported that of 862 emergency physicians polled, 87% felt more stressed since the onset of COVID-19, with 72% experiencing a greater degree of professional burnout, “Yet consistent with a long-standing stigma surrounding physician mental health, 45% weren’t comfortable seeking mental health treatment, citing concerns about workplace stigma and fear of professional reprisal.” Many providers are choosing to leave the profession altogether.
There is no silver bullet for provider burnout — what’s needed is a dramatic transformation in the deep-rooted culture of medicine that continues to push physicians to the brink. However, technology can provide some support in the burnout battle.
Wearables and many apps, for example, can be used to help physicians proactively monitor their own physical and mental well-being and take action before an issue gets worse. Both technologies can collect crucial data from the user, including blood oxygen levels, heart rate, blood pressure, activity level, sleep patterns, and more to help alert the provider to the first signs of burnout and take action.
Provider burnout has been an ongoing problem in the healthcare sector for far too long. We have the innovation available to remove antiquated processes that are weighing providers down and taking them unnecessarily away from patient care. We also have technology in place that can help providers overcome some of the structural challenges that have left them overworked and unsupported. The key is to ensure these tools are supporting providers, not fueling burnout.