IT Complexity and Physician Burn-Out
There are many contributing causes to the problem of “physician burn-out”, some of them much discussed and well-documented, others more insidious.
In the latter category I’d put “healthcare information technology (HIT)”. Generally speaking, HIT is a more obvious frustration for older physicians – people like me, who grew up in the profession using paper charts and orders – because we appreciate how much slower most computerized workflows are than the paper-based systems of days gone by. (Order entry is a case in point.) Younger physicians typically don’t have that point of comparison, since they spent their internships and residencies using hospital information systems (by mandate, not by choice); computerized workflows are all they know. But younger physicians are just as adversely impacted by slower electronic processes as their seniors; they just don’t know it.
Of course, HIT is supposed to be a productivity aid, not an impediment. The healthcare industry has developed and physicians have embraced a lot of technology that boosts productivity, diagnostic accuracy and quality of care, from the stethoscope, to the EKG, to the da Vinci surgical robot. So it’s baffling to me why hospitals seemingly have accepted that many of the HIT systems physicians must use end up costing physicians time and not improving diagnostic accuracy or quality of care. With some older systems, the problem stems from their fundamental design; physician users were an after-thought. With today’s newer EMR systems, the user experience may be better, but the training requirements are onerous; physicians often have to spend days or weeks in a classroom just to begin to learn how to use them.
So on top of everything else contributing to physicians’ growing discontent with the business of practicing medicine – and the list is long – a tool (EMR) that by rights should be a help is instead a hindrance. It’s an unacceptable state of affairs, and should not be accepted by physicians of any age. Nor is it inevitable; there are HIT solutions on the market that run counter to the trend (e.g., PatientKeeper® CPOE™).
It would be too much for a software vendor to take on solving the meta-problem of physician burn-out. However, I take great satisfaction knowing that my company at least is providing physicians with software that does what HIT is supposed to do: Save users time and establish an electronic infrastructure where improving diagnostic accuracy and quality of care is possible.