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Wednesday, March 22, 2017

Is Your EHR Contributing to Physician Burnout? | Depression and Physician Suicide

Health and Wellness applies equally to patients and physicians.   Pamela Wible  focuses on physician suicide and the neglect of emotional illness in physicians points out the unusual stress placed upon medical students, trainees as well as practicing physicians.   She has presented at TedMed, and has published numerous books on the subject. The'Ideal Medical Practice" is taught at several prominent Schools of Medicine.

The concept of the Ideal Medical Practice was founded by Gordon Moore in 2001 well before the health information technology sea change.

Today there is an overemphasis on electronic medical records.  Unfortunately, as many adopters have learned the EHR may not contribute to improved medical care, but decreased efficiency and increased frustration to all health care providers.  Most of this has been inflicted by government and health insurance companies.

The work flow has been adapted to boiler plate electronic health record design, rather than EHR designed to the work flow.  At first glance this is the main reason for intense provider dissatisfaction with most current software design.  Another contribution is the rapid increase of requirements due to simultaneous demands of meaningful use, changing to the ICD 10 codes, new requirements for management of accountable care organizations and a finite limit to resources for the requirements.  The cost of these changes was partially offset by HITECH incentives, although they were inadequate for many providers. Ongoing maintenance requirements were totally ignored by HITECH.

All of these factors increase the likelihood of physician burnout.  Physicians are trained and inherently devoted to caring for  patients with complex problems.  EHRs create one more energy drain for doctors and nurses alike.  It has upset the balance of work-life, health and wellness.

The burden falls to providers facing diminished reimbursements.  Decreasing profitably and outright becoming insolvent in today's environment weight heavily upon physicians who are now locked in by obligations, ongoing professional responsibilities add to hopelessness, and despondency.  Physicians are trained to overcome difficult situations, and can manage problems.  EHRs and bureaucracy are often not manageable and greatly influence physician wellness.

Although physicians are proactive and outspoken, the administrators and regulators often do not listen. Congress does not listen.

Two weeks ago, the American Medical Association’s immediate past president, Dr. Steven Stack, chose what seemed like an odd venue to mention something called the “Quadruple Aim.”
He was giving remarks at the grand opening of the OSF Simulation Stage at healthcare startup incubator Matter in Chicago. The AMA supports Matter and has a lab of its own, the AMA Interaction Studio, in the same facility.  “We need to restore joy to the practice of medicine,” Stack said on the very day the Annals of Internal Medicine published an AMA-supported study showing that physician waste huge chunks of their day on administrative tasks. Notably, doctors in four ambulatory specialties were tied up on electronic health records and other desk work for 49 percent of the work day, the research found.   “We have got to get to the Quadruple Aim,” Stack said. That means the Triple Aim of safer patient care, better population health and lower costs, plus a fourth element, clinician satisfaction.

Is Your EHR Contributing to Physician Burnout? | EMR and HIPAA

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