David Lareau is CEO of Medicomp Systems, a provider of physician-driven point-of care solutions that fix EHRs.
In January, I was among many who predicted that Amazon, Google and other big tech giants would be grabbing health care headlines this year as they fought to gain control of the volume of clinical data stored in electronic health records (EHRs). Obviously, the big headlines this year have not focused on big tech but on big challenges surrounding the pandemic.
While we did not predict the coronavirus pandemic, I am confident in forecasting a parallel phenomenon threatening damage to the mental and physical health of physicians and nurses. In the midst of the current health crisis, clinician burnout is rising rapidly — and health care leaders and technology providers should act now to improve the clinical usability of EHRs.
The Parallel Pandemic
Even before the virus, as many as 45% to 55% of health professionals were suffering from professional burnout, according to a recent opinion piece in the NEJM. I agree with the authors, who noted that Covid-19 is creating a “parallel pandemic” for health care workers facing a surge of physical and emotional harm. Not surprisingly, 52% of health care providers who participated in a recent survey by LocumTenens.com reported experiencing increases in stress, burnout or mental health issues due to Covid-19.
Clinician burnout is a serious health concern linked to an increased risk of cardiovascular disease, decreased life expectancy, depression and suicide. It is also associated with poorer patient outcomes, increased risk for patient safety incidents and reduced patient satisfaction.
To fight this parallel pandemic, health care leaders and technology providers should provide physicians and nurses with solutions that reduce the known contributors to burnout. These include cumbersome electronic health record (EHR) systems, inefficient workflows, interoperability issues and the lack of “clean” data for efficient decision-making.
Improving EHR Usability
The correlation between burnout rates and EHR usability is well-established. A University of New Mexico study attributed 40% of physician burnout and stress to clinical process design and clinical culture (both of which are impacted by EHRs), while 71% of physicians participating in a Stanford Medicine and Harris Poll survey agreed that EHRs “greatly contribute” to physician burnout.
One way to improve EHR usability is to introduce artificial intelligence (AI)-based technologies that improve workflows and make patient and problem-specific information more accessible at the point of care. Many EHRs require users to search through multiple screens to find relevant data. Such inefficiencies can decrease clinician productivity and take away from direct patient care.
In addition to my company’s technology, another example is Enlitic, which uses deep learning to analyze data to streamline radiology diagnoses by giving doctors better insight into a patient’s needs. Another example is Freenome, which uses AI in screenings to detect cancer in its earliest stages.
What clinicians need is access to pertinent details in a patient’s chart related to specific problems or diseases. This is critical when treating patients with chronic diseases who have multiple records.
By adding AI-powered technologies, organizations can improve the usability of their existing EHRs. They can use such tools to quickly identify and interpret clinical information from multiple sources to improve patient care and minimize clinician frustration.
Another often-discussed challenge for health care providers is the lack of interoperability between clinical systems and health care organizations. In March, the U.S. Department of Health and Human Services (HHS) finalized a set of rules designed to improve interoperability. A month later, HHS announced that enforcement of the rules would be delayed until 2021. This allowed providers to focus on the immediate health crisis and extended the time to install the necessary infrastructure.
According to 590 health care leaders participating in a recent Black Book survey, the absence of true interoperability has detracted from Covid-19 patient care. Ninety-three percent of the survey participants reported that complete patient health pictures were not reaching downstream Covid-19 clinicians upon admission, which could lead to poorer health outcomes and increased expenditures.
Clinicians, researchers, public health officials and regulatory agencies have an increased need to share critical patient information related to Covid-19, as well as patients’ preexisting conditions and medications. Health care professionals do not have time to spend hours a day manually searching through clinical systems to find the information they need.
While health care leaders may have to delay system-wide interoperability enhancements, they can add third-party solutions like the ones above to their existing EHRs to facilitate the transfer and exchange of clinical information. For example, applying mapping tools to certain clinical concepts would result in diagnoses, medications, laboratory tests and similar information becoming standardized within the EHR so users can then gain immediate access to the essential details they need.
Facilitating Clean Data
Clinician frustration and burnout can also be diminished if health care leaders can leverage technology to reduce the tsunami of redundant or irrelevant data in clinical systems. Patient care can be optimized when physicians and nurses have access to a patient’s complete medical history.
As we continue to fight Covid-19, we must simultaneously take action to minimize the damaging impact of a parallel pandemic that threatens the well-being of health care professionals. Health care leaders and technology providers should work together to add solutions that enhance the usability of EHRs, improve interoperability, and deliver users clean data that facilitates clinical decision-making.
To help health care leaders choose the right solutions for their organizations, it’s essential that they include their providers as part of the process. Including them in the selection and implementation of the technology will avoid frustrations in the future. Health care leaders need to survey providers regarding their existing EHR to uncover the flaws and benefits in order to best determine the needs for additional solutions. Lastly, health care leaders should have an understanding of timelines for how quickly they need the technology to be implemented and the overall budget they have available.
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