Recently a group of healthcare CEOs co-authored a post in Health Affairs Blog to voice their concerns about the growing problem of physician burnout. It is a complex issue with many causes and implications. The authors of the post write:
“The spike in reported burnout is directly attributable to loss of control over work, increased performance measurement (quality, cost, patient experience), the increasing complexity of medical care, the implementation of electronic health records (EHRs), and profound inefficiencies in the practice environment, all of which have altered workflows and patient interactions.”
The EHR component of the problem is both well documented and particularly unfortunate, as it could have been avoided had healthcare IT innovation been allowed to follow its natural course. In 2008, comprehensive EHR systems were deployed in less than three percent of U.S. hospitals; a greater number had more limited EHRs, but still only about five percent of hospital orders were entered electronically and even fewer notes. The reason for this was simple: the state of the art in healthcare IT was such that it was more efficient for providers to work on paper (frequently in conjunction with a computer) than to work completely in the computer. Users were making a rational set of choices. The 2009 HITECH Act, which added $40 billion in incentives and thousands of pages of often-byzantine legislation, did nothing to improve this, and in many ways made it worse. So now we have “forced adoption” of technology that otherwise would have had to improve dramatically before it would be voluntarily adopted.
Perhaps now, as Meaningful Use winds down, unfettered innovation will lead to what should have come years ago: more physician-friendly systems that make technology an asset, rather than a hindrance, in fostering smoother clinical workflows (and better patient care). Physicians still will feel plenty of pressures, but at least technology won’t add to them.