In the 18 months since Geneia conducted a national physician satisfaction survey and published its Physician Misery Index, the issue of physician burnout has galvanized industry leaders and government officials. When Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services (CMS), released the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) proposed rule earlier this year, he said MACRA is intended to “make amends for the electronic health records (EHR) Meaningful Use program and other reporting requirements that have left doctors feeling over-regulated and over-measured.” He pledged to “put physicians back in control.”
The physician burnout headlines suggest that much, if not all, of the problem is due to EHRs. Yet, the Geneia survey found the issue of technology in the workplace is much more nuanced.
Physician views on EHRs are representative of their mixed feelings about technology. When asked whether the implementation of EHRs has had a positive or negative impact on their work,
- 24 percent of physicians said positive,
- 19 percent negative,
- 53 percent a little of both, and
- 5 percent said they do not use EHRs
Physician sentiment towards data and analytics tools is similarly complex.
The physicians in our survey said data and analytics tools have the potential to reduce time spent on recordkeeping, one of their primary frustrations with the current practice of medicine, while also contributing to it.
When asked their impression of the impact data and analytics tools have on the practice of medicine,
- 69 percent of physicians felt they positively impacted their ability to efficiently assess patient history and needs,
- 63 percent said they help them get value and improved outcomes from chart documentation, and
- Nearly 60 percent felt they helped identify and triage the highest need patients and created greater efficiencies in office workflow.
On the other hand, more than 60 percent of physicians said data and analytics tools have negatively impacted recordkeeping time.
Perhaps it is because of the complex nature of technology in medicine that there are divergent views on preserving existing physician workflows. I recently participated in a HealthsystemCIO.com webinar, The Art & Science of Population Health Management, with two industry leaders: Frank DiSanzo, CIO and chief strategy officer at St. Peter’s University Hospital Health System and Neal Ganguly, VP and CIO for the JFK Health System.
In response to an audience question, the three of us had an impromptu and spirited debate about the importance of maintaining physician workflows. DiSanzo suggested that physicians need to be flexible and open to new, innovative ways of doing patient care, “The old processes don’t pass muster for a variety of reasons, especially the changes in reimbursement. That means workflows may need to be modified with the goal of giving physicians easy access to all of the pertinent patient information in one place.”
Ganguly generally agreed with DiSanzo and added, “Very often clinicians have created their own unique workflow. We need to standardize workflows and create ones that complement the technology and support what needs to happen to collect data appropriately.”
On the other hand, our philosophy at Geneia is physicians and care teams cannot be expected to exit out of their existing workflow. Instead, technology and analytics tools need to pull in and aggregate data from multiple sources including EHRs, physician notes, diagnoses, lab results, prescription drugs, and even wearables, and then present the curated data in a way that complements and adds actionable insights into the workflow.
That’s the philosophy we used to create the Theon® platform, our robust analytics solution that readily yields insights that help bridge the gaps in facilitating care transitions. Providers can access a comprehensive view of an individual patients overall health, level of risk, clinical events and provider interactions across multiple providers. Care coordinators can review lists of patients discharged from the hospital in the past 10 days who have not had a follow-up appointment, see patients who are accessing emergency department services at aberrant rates, and identify patients with more than $100,000 in medical costs who have not seen their primary care physician in more than 12 months. The platform has also helped restore the Joy of Medicine to Dr. Allen and other physicians by helping them reduce their administrative burden and regain 90 minutes each day.
Ultimately, the future will probably mean a balance and perhaps a discovery of better ways of accomplishing the same tasks, made easier with technology. And that is consistent with our philosophy at Geneia that technology should help, not hinder, and with our belief that population health management really is an art and science.