Report: Health IT improvements needed to reduce clinician burnout

With clinician burnout at epidemic levels, the U.S. healthcare system must make health information technology easier to use in an increasingly stressful work environment.

With clinician burnout at epidemic levels, the U.S. healthcare system must make health information technology easier to use in an increasingly stressful work environment.

That’s among the recommendations of a new National Academy of Medicine report, which finds that the rates of burnout among clinicians are alarming.

NAM blames the fact that between one-third and one-half of U.S. clinicians experience burnout from a number of factors, including high workloads, administrative burden and poorly designed technologies.

“Technology can either contribute to clinician burnout (e.g., poorly designed electronic health record technologies) or potentially reduce clinician burnout (e.g., well-functioning patient communications, clinical decision support) if it is well designed, implemented, and integrated into clinical workflow,” states NAM’s report.

According to NAM, the technology that plays the biggest role in creating work frustration and contributing to clinician burnout is the EHR. As a result, the report calls for improving the usability, workflow integration and interoperability of health IT—including, but not limited to, EHRs.

“The usability and interoperability problems with the EHR, combined with the demands of documentation and reporting requirements, create an administrative and clerical burden for clinicians that allows less time for patient care or non-work-related activities,” contends NAM.

To improve health IT usability and interoperability, as well as reduce administrative burden, the report makes the case that EHR vendors, payers, providers and regulators must work together to find solutions.

NAM recommends that stakeholders should “engage clinicians in the design and deployment of health IT using human-centered design and human factors and systems engineering approaches to ensure the effectiveness, efficiency, usability, and safety of the technology.”

Specifically, the report advises the following actions:

• Regulators should use rigorous human factors usability and safety criteria to evaluate and certify health IT.

• HIT vendors and healthcare organizations should design and configure systems to improve the clinical work environment, including attention to cognitive load and workflows that reduce the demand of clinical documentation and automate non-essential tasks.

• HIT vendors, healthcare organizations and regulators should closely monitor implemented technology for negative consequences and should have an existing mitigation plan to address them as they arise.

• Policy makers and organizational leaders should create incentives for, and lower barriers to, the development and implementation of new ideas, approaches, and technologies that have the promise of enhancing professional well-being as well as improving the quality of care.

“Deliberate national and organizational investments in iterative improvements in health IT using a human-centered systems approach can reasonably be expected to pay off in terms of both better patient and clinician outcomes,” concludes NAM. “The EHRs with well-designed features that are deployed with an attention to clinical workflow can improve care effectiveness and safety.”

The bottom line: while there is no single solution to achieve the changes that are needed, U.S. healthcare leaders must make an immediate commitment to solve the widespread problem of clinician burnout.

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