Easing physician burnout with better physician-driven communication

Physician burnout is an increasing problem in US health care systems. In the MedScape LifeStyle Report 2017: Race and Ethnicity, Bias and Burnout of 14,000 physicians, 51% reported burnout, versus 40% in 2013, an increase of more than 25%. Among Family Medicine providers, the reported burnout rate is 55%.

An understanding of the causes and impacts of physician burnout can help health care systems implement solutions to better support their physicians so they can reduce burnout.

Causes of Burnout

Physicians simply don’t have enough hours in the day to meet all of the demands of their jobs.   A report from the Centers for Disease Control and Prevention indicates that physicians would need to work 21.7 hours a day to provide complete preventative, chronic and acute medical care to their patients. Add to that all of their administrative tasks, and the job can be overwhelming. In fact, the top cause of physician burnout according to the MedScape LifeStyle Report 2017 is “too many bureaucratic tasks” followed by “spending too many hours at work,” and “feeling like just a cog in a wheel.” Many physicians will indicate that they spend too little time taking care of patients and too much time on regulatory compliance, documentation and administrative tasks.

 Physician Burnout and the Impact on Care

Physicians experiencing burnout report being overwhelmed by their responsibilities and unable to successfully complete their jobs. This leads to increasing feelings of pessimism, hopelessness and emotional and physical fatigue. Their sense of what they can personally accomplish diminishes, as does their overall interest in work. Physicians who report burnout often have less energy, may start to question their abilities and may reduce their hours or stop practicing all together.

Not surprisingly, physicians with burnout report being more distracted and less able to focus on patient needs and may make more mistakes. Due to their experience of low energy, they also may take short cuts in patient care.

Addressing Physician Burnout

Health care systems recognize the problem of physician burnout, and some are implementing initiatives to address the issue. The Mayo Clinic is focusing on ways to build collaboration and companionship amongst physicians, while the Cleveland Clinic has implemented training sessions to improve patient communication skills. Addressing the challenges that physicians face in the workplace can yield positive results. Initial studies indicate that improvements in leadership, workflow and communication are helping to reduce physician burnout. Additional solutions include teaching physicians ways to deal with stress including mindfulness and stress reduction.

Solutions that improve communication and reduce bureaucratic tasks can also be helpful. Our RapidConnect secure messaging communication platform was developed by physicians to help alleviate some of the things physicians find frustrating and most wasteful of their time. RapidConnect reduces communication barriers and streamlines collaboration with other physicians and caregivers. It also gives physicians more control over how and when they respond, or even who responds on their behalf — by working within their existing workflow and/or staff hierarchy. This improves overall physician and staff efficiency, freeing up time for meaningful patient interaction.

To fully address physician burnout, more initiatives are needed that will assist physicians with managing all of the demands on their time while reinforcing their sense of value in their work. The good news is that health care systems are recognizing the magnitude of the problem and more are working on initiatives to prevent physician burnout.

 


Are You Asking The Right Questions In Your Secure Text Messaging RFP?

As discussed in a previous post, there have been numerous false starts and failures in the implementation of secure text messaging platforms in the healthcare environment.  The landscape is littered with expensive solutions that have seen low utilization, projects being shelved and as a result patient health information continuing to be shared via unsecured methods.

The primary reason for this situation is poor adoption by physicians and subsequently inconsistent use throughout the system. Poor adoption leads to overall poor utilization and a lot of wasted time, money and energy.

But physicians and care providers aren’t to blame. The blame falls on the technology itself. Few of the existing secure messaging products were designed to work with physician workflows and account for physicians need to control accessibility.  Most physicians do not want others to have ‘open access’ to them, nor do they want to ‘sign in’ when they are available or remember to ‘sign out’ when they are not available.

While other technology vendors have provided public RFP templates for secure messaging, those templates focus primarily on the core functionality and the technical requirements of an individual product. They do little to highlight those functional features that will actually encourage broad physician adoption. So, while these templates are helpful, they do not necessarily help you achieve your goal of high user adoption.

With the goal of high user adoption in mind, here are seven key functionality questions you should include as part of your RFP for secure text messaging:

  1. Does the technology automatically route certain types of messages to the physicians designated resource? This might be a resident, PA, fellow, or other clinical staff member. Physicians need control over their access and most solutions don’t offer a way to integrate these physician preferences into their applications.
  2. How do physicians control their availability when they are not on call? Asking physicians to check in and check out every time they want to be unavailable is not a viable solution, and quite frankly, physicians won’t do it.  Look for a solution with one time availability set up that accounts for call and clinical duties.
  3. What happens when a message comes to a physician’s phone when they are in the middle of a procedure?  This is one of the biggest complaints about secure messaging applications.  The application should have an ability for scrub nurses or other providers in the OR to proxy into the physician’s account without having to access the phone. This allows timely response without the OR staff having to access doctor’s personal cell phone and pass words.
  4. Does the platform allow for the user to identify and contact the patient’s current care team (including currently attending hospitalists and nursing staff) through one click access? Having to sift through the frequently long and comprehensive ‘care team’ listing in the EMR does little to facilitate fast, seamless interaction to those who are taking care of the patient at the moment.
  5. Does the application integrate with call centers and other communication systems? Doctors don’t want to carry multiple devices. If secure texting is utilized as the primary method of contacting doctors (which increases adoption), the application needs to be integrated into the call center and function within the parameters of the call centers existing workflows
  6. Does the application architecture and pricing allow for broad distribution to outpatient-based physicians, including regional referring doctors without running afoul of anti-kickback laws and incurring additional costs? Many current technologies offer ‘per head’ licensing, which a) limits the distribution of the product, limiting the overall adoption (see point above). Also, the technical architecture needs to ensure the application can be provided to these referring physicians without fear of giving something of value to these doctors.
  7. Does the application integrate with nurse duty phones? Maximizing nurse/patient interactions is critical. If nurses have to use a desktop-based application, this reduces the available time for patient/nurse contact. Similar to the point above, if the system is to be charged for every downloaded application, adding the hospital-based nurses to the installation can be extremely expensive.  Evaluators should look for a product that not only encourages broad distribution, but facilitates that through enterprise-based pricing and integrates with nurse duty phones to maximize patient contact.

Healing What Ails Healthcare Technology Adoption

The marriage between technology and physicians is not always an easy one and there have been a lot of bad breakups over the years. After all, physicians went to medical school to treat patients, change the world, etc. They did not set out to learn a new technology every time they turn around and/or to play a leading role in technology implementations. Yet today, they are finding themselves playing that role and feeling the frustrations that go along with that.

There is no shortage of research that talks about the challenges vendors face when it comes to technology adoption with physicians (and healthcare in general). Look no further than the EHR (electronic health record) technology market to learn more about those challenges and the lessons learned from them. In a 2015 study by Physicians Practice, physicians cite a long list of technology challenges (many of which relate to their experience with EHR technology), including: a drop in productivity when rolling out new technology; lack of interoperability between technologies; meeting regulatory requirements; cost to implement and use technology; resistance to technology; security and training.

MD Interconnect co-founder Dr. David Hoover was all too familiar with those challenges, having been on the user side (the resistance side may be more accurate) of numerous technology rollouts. He knew that MD Interconnect had to do things differently to ensure successful adoption.

With this in mind, the MD Interconnect team took a two-pronged approach to adoption. The first approach may seem obvious: design a product that solves a meaningful problem, but design it with your users (i.e. physicians, etc.) and their workflows (maybe not as obvious) in mind. Surprisingly, many technology companies develop a product that solves the first issue (meaningful problem) but neglect to consider the second (user workflows and preferences). Consequently, they experience poor adoption, limiting and or even eliminating the product’s ability to succeed.

The second approach is equally important but often overlooked – build an implementation process tailored to address a physician’s unique objections/concerns with an understanding of their job, their workflow, their practice, etc. With that in mind, you need to make it as easy as possible for them to get on board (hand-holding as needed), quickly demonstrate the value of using the technology (what’s in it for them), and ensure that they are motivated to continue using it (continued engagement, tracking, etc.).

When it comes to developing a secure communication solution for hospitals, there are some basic features and functionality that every solution must have at its core. The solution must successfully facilitate the delivery of messages between users. And, the solution must address mounting security requirements that hospitals face, including the need for HIPAA compliance. There are a number of vendors that offer products that address those core requirements, but MD Interconnect created a solution that goes beyond these basic requirements to engage users and ensure adoption. You can learn more about the company’s physician-driven design in this previous blog post. Here are some of the factors MD Interconnect considered while developing a product with adoption and sustained engagement in mind:

  • Physician adoption is of the highest priority. Lead with them and the rest will follow.
  • You must make it quick and easy for messages to be read, and provide visibility to senders about that status.
  • You must consider a physician’s personal preferences about when they should be reached and when they should not.
  • Call schedules and call hierarchies must be integrated into the communication platform.
  • It should also support the teaching hospital hierarchy and include residents, APPs, fellows and attendings at the appropriate times.
  • You must consider times when a physician cannot safely respond to a message, making it easy (and secure) for a proxy to respond on their behalf. See this blog post on RapidPair to learn more.
  • You must address the differences between cell phones and pagers, as well as the unique challenges, benefits, and behaviors associated with each.
  • Your pricing model must encourage adoption by the entire patient care team/community.
  • The ability to easily forward a message chain to a support team, including clinic schedulers and bed management must be built into the solution.

With RapidConnect, MD Interconnect knew they had a great product that hospitals, physicians and patients would benefit from, but they also knew their job wasn’t done. See our next blog post on what it takes to ensure a successful implementation and ongoing user engagement.