Physician burnout was an acknowledged problem long before the pandemic hit.
But now doctors who were previously burdened with lack of autonomy and pressure to pack their days with too many patients are now grappling with the existential threat that is COVID. We see it in the fear for themselves; their families, their colleagues and their patients; lack of PPE, the list goes on. In a bleak reminder that doctors are people too, one recent study shows the effects of this additional stress: 50 percent of doctors surveyed had signs of depression, over 70 percent felt distress, 34 percent had insomnia.
In the next year, the pandemic will recede. Life will return to at least a semblance of normalcy. But it still won’t be appreciably better for physicians because it was too much even before COVID-19. More must be done to address physician burnout. Fortunately, technology can carry some of that incredible load. But it has to be developed in the right way to make a heavy lift a little lighter.
That comes down to a few key elements: building systems for the intended audience, tightening team connections, designing communication-first technology, and bringing back the patient story.
Where current systems fall short
Traditional electronic medical records (EMR) systems are often all encompassing. That’s not a compliment. They’re a classic example of, to paraphrase an old saying, trying to please everyone and ending up pleasing no one. Most EMRs are behemoths: built for as many specialties and providers as possible. As a consequence of adding so much functionality, it’s become very difficult to follow the patient journey. It’s buried in menus and sub-menus, making it insanely time consuming to unearth information; it’s death by a thousand clicks.
What’s more: the focus of the system is less about the patient and more about ensuring that specific codes and data are included and accessible to satisfy billing. But a ‘by administrators, for administrators’ approach robs doctors of the time they should be spending with patients and considering their care on an ongoing, wellness-focused basis. As a care community, what we really need are technology solutions that are elegant in their simplicity and ease of use. They need to put the patient front and center at all times and make doctors’ lives easier – otherwise what’s the point?
Tightening team connections
EMRs make it very difficult for a care team to be on the same page. I personally have to hunt and peck countless times trying to figure out what someone else did for my patient. It’s frustrating. We can’t see the whole story at a single glance. For someone outside our world, the assumption is that the doctor is always the driver. In fact, it’s much more involved. A diabetic patient, for example, might have a primary care doctor, a nutritionist, an endocrinologist, an ophthalmologist, a counselor, etc. Without a holistic view that allows us to understand the observations, conclusions and recommendations we each have about this patient, and to communicate with each other, we can’t deliver the best possible care.
It also puts unwarranted pressure on patients to tell us what our peers involved in their care have done for them. Sometimes patients won’t even think to do that (and, of course, it shouldn’t be on them to do so).
EMRs typically offer patient portals where you can send messages to patients. Sounds great in theory but in practice, it’s typically a pretty friction-filled experience with poor uptake as a result. Those patients who do make the effort to get in find it difficult to navigate, small print that’s challenging to read, etc. Most patients want something akin to their iPhone experience: simple, intuitive, straightforward. A text with a hyperlink to a message is an easy way to solve that problem.
Doctors also want a single-click method for communicating with their patients. The options for secure video, text, calls and emails should all be at our fingertips so it’s effortless to keep that connection ongoing. A communication-first technology platform would go a long way toward helping us reframe our focus on care so it’s concentrated on wellness and prevention.
Bring back that patient story
EMRs have produced a very sterile, clinical approach to patient care. That’s what you want in an exam room or on the operating table, but it’s a weakness in the overall structure of medical care delivery. The paper charts of the past – while certainly not clickable – gave us much more of the useful color and texture around the patient journey. You could flip back and see exactly what’s going on, who said and did what, prior to seeing your patient. EMRs promise to do that but they don’t really deliver. But a better technology could do that for us.
The other element to consider is how much of that patient story we’re getting in the exam room itself. If we’re so focused on what we have to enter in the system, we’re spending less time looking at the patient, being present with them, giving them empathy, and building a real connection. And patients notice (“The doctor spent the whole time looking at the screen, not at me.”). It’s hard to develop trust when your focus is split between a screen and the person who needs your complete attention. That’s why companies like Suki.ai, a voice-enabled digital assistant, might point the way to a different, more patient-positive future.
Physician burnout can’t be solved only with technology. None of us are naive enough to think that’s true. But the reality is, it can help us get a lot better. Patients and healthcare professionals alike will benefit.
About the Author:
Dr. Rawlinson is an entrepreneurial physician executive, strategic leader, and digital healthcare product innovator. He is passionate about creating digital tools and new delivery models that reduce waste and inefficiency, improve quality, and drive improved performance and satisfaction.
Dr. Rawlinson volunteers for The Maven Project and Rotacare Bay Area. He tweets @CMIO. He is an avid road cyclist and a big fan of Manchester City FC in the English Premier League!