Physician Burnout: Chipping Away at Unnecessary EHR Burden

More often than not, physicians are viewed as caring, selfless, and knowledgeable individuals. They spend years of their lives training to take care of the sick and improve the overall health of the people around them. But in today’s day and age, physicians are being pushed to their breaking point. Many have found that they have a low sense of accomplishment, diminishing productivity levels, and poor self-care routines – causing many to leave the profession they love.¹

What is often found to be the most common cause of this ‘physician burnout’ phenomenon?  Technology.

The Electronic Health Record (EHR) – technology designed to provide a consistent, safe, and efficient patient and provider experience – causes more headaches than any other tool a physician might use.  One study found that over 48% of physician burnout was attributed directly to the EHR.²  Further, 64% of physicians agreed or strongly agreed that EHRs added to their daily frustration level.³  Every year, physicians voice that tasks are taking longer and there are new hurdles adding layers of complexity to providing care.  As Dr. Gary Price from The Physicians Foundation stated in a recent podcast interview, “physicians are being asked to do more and more in less and less time… they are being asked to do administrative and regulatory chores, and unfortunately, our technology hasn’t given them the tools that facilitate that.”⁴  Reporting, documentation, and billing processes must be completed in order for hospitals to be accredited and reimbursed, but physicians are now spending two hours in the EHR for every one hour of patient care!⁵  To put it bluntly, doctors who spent years learning how to care for patients are now spending twice as much time heads-down in technology, managing health records and recording data.

Health systems and vendors need to prioritize physician satisfaction and eliminate unnecessary burden since the estimated cost to replace a physician can often exceed one million dollars.  Additionally, there is evidence that physicians experiencing burnout impact healthcare expenditures through medical errors, malpractice claims, absenteeism, and lower productivity.¹

EHRs and complex EHR processes are also a contributing factor in lower patient satisfaction and care quality scores, since patients are often competing for their physician’s attention in the doctor’s office.  Almost every patient has been in a situation where a caretaker has their back turned, scouring the EHR for a diagnosis code or data point.  This causes physicians to miss non-verbal cues that could be important in effective diagnosing.  It is no coincidence that many physicians offload EHR work to their teams so they can spend more time caring for patients.  However, this habit can cause input errors since teams are not necessarily directly involved in diagnosis and interfacing at the point-of-care.

In an eye-opening study about the usability of technology across various sectors, researchers found that Google scored a 93 and Microsoft Excel, the often-disliked data management tool, scored a 57.  What is astonishing however, is that the average EHR score was just 46!⁵  Now why might that be?  Take this example from a separate study which included four health systems who collected data on EHR keystrokes and mouse clicks.  The results showed that prescribers had to click anywhere from 14 to 62 times to complete a prescription order for Tylenol.  And to complete a prednisone taper order, prescribers clicked anywhere from 20-42 times.⁶  While time spent prescribing drugs is only a tiny fraction of the total time a physician might spend in the EHR, it is clear that each burdensome task can contribute to added stress and potential burnout.

There are nationwide workstreams in progress to help reduce physician hurdles, lessen EHR burden, and improve physician satisfaction, but companies like Arrive Health are chipping away at different issues with the hope we can bring doctors back to the forefront of the care journey.  Arrive Health focuses specifically on streamlining the prescribing process by displaying patient-specific, formulary-driven alternatives in-workflow, so doctors can avoid prior authorizations, coverage restrictions, and pharmacy callbacks – which can take up to 20 hours of a care team’s time per week.⁷  By providing accurate data in real-time, doctors can be assured that when they select a specific medication, they are seeing cost-effective, clinically-relevant drugs that their patients can afford.  Instead of prescribers taking dozens of clicks to understand which drugs might be covered or available at a specific pharmacy, prescribers that use Real-Time Prescription Benefit tools, like the one Arrive Health offers, can be assured that they are viewing the right drugs, at the right time.  In this way, Arrive Health’s RTPB technology is streamlining the prescribing process, which in turn can help physicians feel like the EHR – and the data within – is helping them provide better care to their patients.

As mentioned earlier, physicians are feeling a diminished sense of accomplishment and are overwhelmed by the technology they have at their disposal.  Tools and applications within the EHR should be designed to improve the care workflow, but many have added additional burden and prevent effective care.  Throughout Arrive Health’s history, we have iterated on solutions that show clinically viable medications with the least number of EHR clicks. We are working with the industry’s leading EHR vendors to understand UX and UI constraints, and are constantly thinking about how we can improve EHR usability to reduce friction in the prescribing process and allow physicians to work at the top of their license.  We encourage all healthcare technology companies to join us in bringing physicians to the forefront so we can better prioritize patient care.

1. Physician Burnout: Contributors, Consequences, and Solutions – C.P. West, L.N. Dyrbye, T.D. Shanafelt, Journal of Internal Medicine: 2018.
2. Study Shows Physician Burnout Directly Related to EHRs – Christopher Jason, EHR Intelligence: 2019.
3. Study: EHRs Contribute to Family Physician Stress, Burnout – Michael Devitt, American Academy of Family Physicians: 2019.
4. EHR Usability Fixes to Address Physician Burnout, Engagement – Gary Price MD, Xtelligent Healthcare Strategies Podcast: 2020.
5. New Research Links Hard-to-Use EHRs and Physician Burnout – Kevin O’Reilly, American Medical Association: 2019.
6. A Usability and Safety Analysis of Electronic Health Records: A Multi-Center Study – Raj Ratwani, Erica Savage, et al., Journal of the American Medical Informatics Association: 2018.
7. Prior Authorizations: The Saga Continues for Providers – Lisa Remington, Remington Report: 2019.