EHRs get most blame for epidemic of physician burnout

For every hour doctors spend on direct patient care, they spend two hours on data entry and administrative tasks.

The problem of physician burnout is affecting about 50 percent of practicing doctors, and electronic health records are squarely to blame, according to Michael Hodgkins, MD, CMIO at the American Medical Association.

A major contributing factor to this professional dissatisfaction is the fact that for every hour physicians spend on direct patient care, they spend two hours on EHR data entry and other administrative tasks.

“Think about that—twice as much time tending to things that really have very little or nothing to do with direct patient care,” Hodgkins told a CMIO roundtable on Tuesday at the HIMSS18 conference in Las Vegas. “When physicians are not involved in how these tools are created, designed and implemented, there are problems.”

This work imbalance is leading to emotional exhaustion, depersonalization, as well as feelings of low achievement and decreased effectiveness among doctors.

“We know from a series of studies that what motivates physicians is time with patients,” says AMA CEO James Madara, MD. “We want technology, but only technology that works.”

Madara contends that clinicians currently are relegated to the role of glorified data entry clerks, which is a “terrible use of the workforce and terrible result for both the physicians and patients.”

Also See: EHR, CPOE use linked to physician burnout and dissatisfaction

Not surprisingly, physicians who work in medical specialties on the frontlines of healthcare—such as emergency medicine, family medicine and general internal medicine—are at the highest burnout risk.

“Burnout is associated with bad outcomes in clinical care,” contends Hodgkins. “Burned out physicians do a poor job and create more patient safety events than their colleagues who don’t report significant symptoms.”

It’s the reason that CEOs from some of the country’s most respected healthcare organizations published a paper last year in Health Affairs concluding that physician burnout is a nationwide public health crisis.

In addition, physician burnout is also having a financial impact on health systems’ bottom lines.

According to Hodgkins, the loss of productivity because of EHRs at the national level between 2011 and 2014 is estimated to equate to eliminating the graduating classes of seven medical schools. He also said that replacing a physician who leaves practice because of burnout can cost anywhere from $500,000 to $750,000.

“If your organization isn’t paying attention to this problem, they ought to start,” concluded Hodgkins.

Madara says he is encouraged by the announcement on Tuesday from Centers for Medicare and Medicaid Services Administrator Seema Verma regarding a new Trump Administration initiative—called MyHealthEData—designed in part to streamline documentation and billing requirements for providers to enable doctors to spend more time with their patients.

“When you step back and look at the context—(physicians spending) two hours on administrative tasks for every one hour of seeing patients—it’s not surprising that there are multiple pieces to this,” he adds. “I think there’s promise and potential but we have a long way to go.”

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