Clinician burnout – where's technology when you need it?
Photo: Wolters Kluwer Health
Hospital and health system executives are all too familiar with clinician burnout, an industry-wide problem that threatens healthcare quality and accessibility. Forward thinking execs are on the hunt for strategies and technologies that can help combat burnout and improve the daily lives of their caregivers.
Healthcare IT News spoke recently with Julie Frey, director of product strategy at Wolters Kluwer Health, a developer of clinical decision support tools.
Frey has more than a decade's experience in corporate and product strategy. In her current role as director of provider product strategy at Wolters Kluwer, she works closely with healthcare providers to develop road maps for the future of the company's market-leading solutions, including UpToDate and Lexicomp.
She discusses why she believes clinician burnout is definitely an IT concern, why the time is now for technology leaders to help reverse burnout and the importance of prioritizing tools that clinicians most value. She also offers some best practices for introducing change.
Q. You say clinician burnout is spurred largely by administrative burden and is undoubtedly an IT concern. Please elaborate.
A. A recent piece by the AMA on clinician burnout laid the problem at the feet of administrative burden. The sheer volume of patients, coupled with regulatory and payer requirements, are some of the largest contributors.
But technology also plays a critical role with the number of tools clinicians are required to use, including EHRs, clinician decision support, telehealth platforms, productivity tools and new digital health apps. As this list grows, clinicians face a continual stream of new applications to learn, changes to clinician workflows and additional "clicks."
Each change or addition may only have a small impact, but the aggregate, along with the ongoing stream of new technologies, means overwhelming changes. The end result? Clinician cognitive overload – "burnout."
This burnout affects productivity, morale and, ultimately, clinician retention. Health systems need to focus on ways to enable clinicians to do more of what they love – care for patients.
So, with the issue being at least partially driven by technology, why is IT so underleveraged as an area in helping clinicians achieve this? IT leadership agrees technology must be a core component of addressing today's workforce challenges, including finding ways to support top-of-license practice and increase care team efficiency. If leaders can identify ways to do this with technology, it will have a positive lasting impact on clinicians and their patients.
Q. You also suggest the time is now for IT leaders to play a critical role in reversing clinician burnout. Describe this role.
A. Health systems are expressing a widespread commitment to elevating their IT strategy and specifically focusing on digital transformation. This was already underway, but the pandemic accelerated it.
Based on our discussions with customers, technology is now a key organizational and strategic pillar, alongside areas like clinical care and patient education. And technology leadership – whether it's the CIO, chief digital officer or CMIO – is playing an increasingly strategic role with additional budget.
But, until recently, efforts to modernize and streamline clinician workflows did not rise to the top of the list of competing IT priorities, such as improving virtual care, information security, data analytics and cyber threat response. With such a broad range of important and urgent issues, IT leaders have understandably deprioritized efforts to streamline clinician workflows.
But effective IT workflows underlie a health system's ability to optimize all tech-driven priorities, and the inefficiencies contributing to clinician burnout have ripple effects across the organization.
The good news is that as the link between current technology use and clinician burnout has become increasingly clear, CIOs have shifted their sights to tackle clinician workflows, particularly through the lens of administrative burden.
In the 2022 Academy Priorities Survey, CIOs ranked "developing tech-enabled solutions to reduce care team administrative burden" among their top five priorities. And for 2023 it ranks as a top three priority, alongside implementing practices to improve information security, and enhancing cyber threat incident response and recovery planning.
In this, we see the extremely high organizational cost – in time, money and reputation – of events such as a ransomware attack or data breach are on par with the costs of tech-related workforce burden.
Q. Talk about the importance of prioritizing tools that clinicians most value.
A. Simply put, an investment in a tool that a clinician doesn't like to use is not a good investment. So how do organizations end up with such tools? One IT leader said, "When we do things with technology, we don't often engage multidisciplinary teams. Then you get this reaction of, 'We built it, why won't they come?'"
We see this a lot with our health system customers when the IT organization makes a decision based on criteria that aren't aligned with what their clinicians want and need – they end up onboarding and offboarding another solution.
According to a recent KLAS report looking at the clinician's view on clinical decision support, "Tools that lack strong content, searchability and EMR integration are not efficient for point-of-care workflows and can frustrate users, especially those already experiencing burnout."
Q. What are some best practices for introducing change, including seeking out and incorporating clinical perspectives into decision-making?
A. Partnering with clinicians from the very start of the process for any workflow tool and listening to their needs and pain points is paramount. Healthcare organizations that are doing this well consistently follow a few best practices:
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Seeking out and incorporating clinical leadership and clinician perspectives as they set overall digital strategy and define decision-making processes.
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Consulting clinical staff and administrative teams in designing, piloting and/or testing of applications, processes and workflows. Yes, every step of the way, as the smaller details can often undo a thoughtfully laid out strategy.
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Continuing to involve a multidisciplinary team throughout the lifecycle when scaling additional technology solutions across the organization.
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