Physicians’ Well-Being Linked To In-Basket Messages Generated By Algorithms In Electronic Health …

How well-designed tech can help medical professionals avoid burnout

How should doctors and nurses spend their time? Ideally, talking with patients about their pain and progress, examining their illnesses and injuries, and planning their treatment. But, that’s a shrinking part of clinicians’ days. Luckily, it’s a reversible trend.

A study by the University of Wisconsin last year determined that primary care physicians spend more than half of their working hours on administration such as updating health records, ordering tests and inputting billing codes. Ironically, technology has become the problem — or, rather, poorly designed technology.

Take the electronic medical records systems that health care facilities have rushed to install in the last decade. In theory, they should make clinicians’ lives easier and patient care smoother, but in practice they force doctors and nurses to spend mind-numbing hours each day navigating a maze of screen menus, tabs, forms and buttons. Logging even routine procedures can take a dozen clicks. Such is the burden that “pajama time” has become an industry euphemism for the after-hours admin that’s now a routine part of clinicians’ home lives.

This contributes to extremely high rates of workplace stress among medical personnel – nearly two-thirds of doctors in the U.S. report feeling burned out or depressed. Long-term care facilities have particularly acute problems, with 70% turnover among nurses each year. To halt the trend of doctors and nurses spending a lot of time entering data, health care facilities need to adopt a multi-faceted approach to tech that tackles both the immediate symptoms and the underlying causes:

It’s Time For The Rise of E-Physicians

We strongly believe that only digital health can bring healthcare into the 21st century and make patients the point-of-care. Patient empowerment, the spread of digital technologies and the widening access to medical information coupled with global doctor shortages, rising life expectancy and the ever-higher numbers of chronic diseases call for a change in the practice of medicine. The centuries-old approach to the medical profession cannot deal with the waves of the 21st century. Physicians should experience a shift from the lone wolf to the curious team player, from the rule follower to the creative and from the demigod to the guide in the jungle of digital health. That’s the main argument of the latest publication of The Medical Futurist Institute entitled The Rise of the Empowered Physician in the Digital Health Era published in the Journal of Medical Internet Research.

Atlases holding up an increasingly heavier, ancient world The level of physician burnout is at an all-time high. The President of the World Medical Association, Dr. Leonid Eidelman, started his inauguration speech in October 2018 with addressing the “pandemic of physician burnout”. At that moment, nearly half of the world’s 10 million physicians had symptoms of burnout, including emotional exhaustion, interpersonal disengagement, and a low sense of personal accomplishment, he explained.

The growing number of chronic diseases, global doctor shortages, increasing costs of medical treatment, and rising life expectancy all together result in an immense challenge for medical professionals. Moreover, even innovations that are supposed to help physicians cope with the burden tend to cost in more working hours: electronic medical records, the increasing computerization of the practice coupled with the increase of bureaucratic tasks all add to the burnout epidemic.

So far it seems technology offered more benefits to patients than medical professionals. Patients have more information at their fingertips, have access to many more technologies, smartphone apps, and gadgets aiding their healing process. They can follow their care closely, ask questions, turn to online patient communities for support, go after treatments in foreign countries, etc. It seems that they don’t need the too confident demigod-like physicians of the past anymore. They need partners who can navigate them through the jungle of digital health.

Has Physician Burnout Really Eased? And What Might That Mean for Health IT Leaders?

Scribes improve emergency physicians’ productivity -

A multicentre randomised trial in Australia demonstrated that the use of scribes improved emergency physicians’ productivity, particularly during primary consultations, and decreased patients’ emergency department length of stay. In addition, financial analysis based on gains in productivity and throughput supports implementation of scribes.

A medical scribe helps the physician by doing clerical tasks such as documenting consultations, arranging tests and appointments, booking beds, and completing electronic medical record tasks. The aim of the role is for scribes to do clerical tasks otherwise done by the physician, enabling the physician to manage more patients in the same amount of time.

Scribes in emergency medicine have been reported to increase productivity in some studies and provide no gains in others. Data also show that scribes are well tolerated by patients, and most physicians find working with scribes beneficial. However, no multicentre randomised studies have been done, and patient safety incidents (adverse events or near misses) associated with scribes have not been evaluated. Greater understanding of the effect of scribes on physicians’ productivity will help to inform decisions about whether to start scribe programmes.

For this randomised clinical trial, five emergency departments (EDs) in Victoria used Australian trained scribes during their respective trial periods. Sites were broadly representative of Australian EDs: public (urban, tertiary, regional referral, paediatric) and private, not for profit. Study participants included 88 physicians who were permanent, salaried employees working more than one shift a week and were either emergency consultants or senior registrars in their final year of training; 12 scribes trained at one site and rotated to each study site.

Physicians worked their routine shifts and were randomly allocated a scribe for the duration of their shift. Each site required a minimum of 100 scribed and non-scribed shifts, from November 2015 to January 2018. Main outcome measures were physicians’ productivity (total patients, primary patients); patient throughput (door-to-doctor time, length of stay); and physicians’ productivity in emergency department regions. Self-reported harms of scribes were analysed, and a cost-benefit analysis was done.