Computing in general and electronic health record (EHR) systems in particular are double-edged swords. Their benefits – data quality, accuracy, and processing – can be undermined by the workload, fatigue, and burnout they foster.
That’s why we’ve invested enormous effort in designing a better user experience.
The burnout concern was covered in depth in a recent study on best practices for tech in clinical social work and mental health care. “Use of video and electronic health records were associated with clinician physical and emotional problems due to barriers, effort, cognitive demands, and additional workflow steps,” researchers wrote.
Authors found “low satisfaction with clerical tasks, effort required, and interruptions.” If integrated poorly — without sufficient evaluation of behavioral, cognitive, emotional and physical impact – advances in technology “may inadvertently worsen clinician workload burden, fatigue, and burnout.”
Taking Quadruple Aim
The advent of EHRs mirrors health care’s traditional “triple aim” of improving patient experience, population health, and affordability. At HiMS, our R&D is focused on the newer quadruple aim, which adds “improving the work life of health care providers” to the list.
That’s an important concern. As many as two-thirds of mental health workers may be experiencing high burnout levels. Although you can’t blame it all on technology, technology is part of a complex and potentially toxic blend of heavy workload, interruptions, lean staffing, stress, deadlines, quotas, obstacles, compromises, and individual circumstances. Research has shown that more than half of a physician’s day can be spent in an EHR system, with a lot of that time spent on red tape: documentation, order entry, billing, coding, and prescription refills.
Little attention has gone to addressing these concerns in the behavioral health field, and health care organizations need to fix it. They should develop systematic methods to detect burnout, measure the stress, and reduce the harm.
Doing Our Part
We’re making a complementary effort at HiMS. We believe the EHR should and truly can be an engine for optimizing provider effectiveness – that is, empowering clinical social workers and others, not sapping their energy by shortchanging patients. To empower providers, however, the EHR needs to be radically different than it has been. It needs to serve the user instead of the other way around.
In 2024, an EHR should give care teams more face time with patients and require less time screen time with software. That means less clicking, scrolling, page-switching, and application-toggling. Providers want usability, akin to what a smartphone typically delivers.
Unlike a typical EHR, your smartphone is usable five minutes after you remove it from the box. It’s an object that is at the very least as personal as your wallet or purse, and as necessary. Your smartphone apps and settings can be customized to your own preferences, letting you use it faster and extract more value from it.
That’s what the EHR should be: so much your own and so useful that you feel deeply connected to it. We believe it can be. Our EHR, Axiom, is fully configurable and customizable – not just by an IT department but by each user. Any user will be able make the EHR his or her own by intuitively arranging functions, features, apps, etc., where they like, hiding the ones they don’t need, and driving all of it by voice command if they wish.
We’ve also added AI in a careful way. Our solution listens to a patient-provider conversation, selects the important information that pertains to the discussion, and puts the information where it needs to go to in the clinical record.
Health care is hard, but the technology should be easy. It should make providers better, not burn them out. The solution is paying attention to provider experiences both in R&D and in the health care setting each and every day.
