It’s time to ease clinician burden

Everywhere I went during HIMSS18, people were discussing the topic of the burden of documentation on the clinician. Physicians, nurses, vendors and the Office of the National Coordinator for Healthcare all had sessions that discussed the burden technology has placed on clinicians.

Technology has increased the ease of banking. I can deposit a check from home and have near-immediate access to funds. But in healthcare, we have implemented technology that has added to the workload of our clinicians. Clinician burnout rates are increasing and it is time to help stem that trend.

Click, click, click …

What is the burden and why has it increased? Electronic medical records have made it easy to require documentation, and more and more data points have been added to increase the amount of documentation that is needed for compliance, billing and quality measures. Physicians are now completing electronic orders that require large numbers of mouse clicks.

In fact, one physician told me she has to complete 26 clicks just to order an influenza vaccine. Imagine multiplying this type of data entry as she tries to see 28 to 30 patients a day. Many clinicians are spending hours after seeing their patients completing the charting that goes along with each visit.

In addition to the added burden of documentation, there is now a multitude of data that clinicians must address as they diagnose and treat patients. There are DICOM and non-DICOM images, reports, point of care device information, outside lab reports, etc. The clinician is expected to reference all patient data, but sometimes finding it in a quick and easy way is cumbersome.

“Clinicians complain about logging into electronic health records dozens of times a day,” according to Modern Healthcare. “They complain about clunky navigation and undue documentation requirements that keep them from engaging with patients.”

It’s all about access

Lack of interoperability also adds a burden to our clinicians. Patients refuse tests and imaging because they have already completed these procedures, but the clinicians don’t have access to the results. The clinicians then have to hunt and search for results in order to care for the patient. The government is now focusing on interoperability and information blocking, which indicates it recognizes these issues as burdens on our clinicians.

So, how do we help decrease these burdens?

One of the first things is to have a strong governance program around documentation. Assess what doctors and nurses absolutely have to document, and don’t continue to add to the mountain of data elements they are required to chart on. We all need to evaluate and optimize our documentation screens and templates. Streamline them, pare them down. Included in this should be the ability to have a team approach when charting.

Why should a patient be asked the same questions repeatedly by the intake coordinator, the nurse, the doctor, lab, etc.? Many of the elements of documentation that are being put on the physician could and should be documented by other disciplines. It is time to go back to a team approach for documentation.

Make all patient data easily accessible

Another way to help decrease the burden on our clinicians is to make all patient data easily accessible. Utilizing a tool such as the OnBase patient window, you can organize and access information with a simple user interface directly from the core EMR. Clinicians should never have to leave the EMR to find all the patient chart, so having this functionality makes all information quick and easy to find. Included in that information would be DICOM and non-DICOM images, point-of-care device photos and videos, outside records and other important information that is collected on the patient outside of the EMR.

We have talked about interoperability for years, but it is time to put more functionality into practice. Our healthcare IT vendors need to make sure we are working together for the good of the patient and the clinicians by making sure the data our systems house is available and easy to access.

There have always been challenges and burnout in the healthcare profession, but there are ways to decrease these in the here and now. If we work together to make documentation more streamlined, and make sure our clinicians have access to the full patient record, then we will be taking positive steps forward to start decreasing the burden we put on them. And that goes a long way toward improving patient care.

Lorna Green

Lorna Green

As a registered nurse for more than 30 years, Lorna Green, RN, BSN, worked in a number of healthcare environments – including ICU, Surgery, Home Health and Medical/Surgical Units and as a school nurse – before transitioning to informatics and Health Information Technology in 1999. As Hyland’s Healthcare Informatics Executive Advisor, Lorna provides thought leadership and expertise of the regulations, solutions and trends impacting the informatics discipline within healthcare industry, specializing in clinical processes and quality measures, the Joint Commission standards, Meaningful Use, Interoperability and the HIMSS Analytics EMR adoption model. Lorna earned her bachelor’s degree in nursing from Valdosta State University in Georgia. She joined Hyland in 2010 as a Senior Business Consultant.

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