Your doctor gets through medical school, joins a healthy practice and starts treating patients. Does a doctor at that point get to kick back and take satisfaction that he or she is contributing to the community and fulfilling the Hippocratic oath?
Not really. It is staggering how much paper, faxing, and hard copy still exists in healthcare today. And it’s burning out providers, even recently graduated ones, at crisis levels. There’s an extraordinary number of administrative tasks and responsibilities that weren’t taught in medical school and interrupt actually treating patients: Documentation. Claims and denials. Payer rules. Patient communication. Eligibility checks. Safety routines. Quality program measurement. Changing workflows. Federal uncertainties and boxes to check.
All this remains even as rudimentary electronic health records, or EHRs, have gone into use, especially after the Affordable Healthcare Act (ACA or “Obamacare”) which mandated their wider use.
Recent research shows that just around half of physicians in the U.S. either often or always feel burned out. Physicians are 15 times more likely to experience burnout than professionals in other lines of work. Burnout stems mostly from the non-clinical things like in the list above. An MDVIP survey published in September found that 74 percent of primary care providers cited too much paperwork and bureaucracy as the top cause of burnout. It is not only taking away providers’ after-hours time, but edging into the time they normally spend with patients. Piling on to all this, the tools that were ostensibly designed to help scale back administrative workload—the EHRs, the digital workflows, the seemingly endless screens—are, by and large, only adding to the burden.
My company, athenahealth, recently revealed insights from its Physician Experience Survey, the first survey of its kind to tap into the service-profit chain model and test out the concept of “self-perceived capability,” the belief that doctors have the tools and resources to effectively do their job and serve their customers. What we’ve discovered is that physicians’ levels of capability are closely linked with personal engagement and organizational performance: Physicians who perceive themselves as being capable are more likely to feel engaged in their work and practices, leading to less turnover and higher financially performing organizations.
Most critically, when physicians feel capable, they are less burdened by workloads and have more time to connect with patients and staff. What does this mean? We could help providers feel capable in their day-to-day workflows if we infuse health delivery environments of all sizes with user-friendly and work-reducing platforms, necessary tools and resources, and engaged leaders. It will chip away at the plague of burnout and restore the human touch to healthcare.
Take Lost Rivers Medical Center. A critical-access hospital tucked into the rural hills of Idaho, Lost Rivers had been losing nearly five hours per week, per physician, as they made sure patient charts lined up. This took away from time that could have been spent with patients or in professional and peer development groups. And in a small hospital with everyone wearing forty hats this time lost can be detrimental for the health of patients, providers, and the hospital itself. A cloud-based platform, paired with the right set of results-oriented services, alleviated the burden of charts, documentation, and coordinating care, without inflating costs or reducing headcount. As a result, Lost Rivers’ providers and staff were unburdened, able to go home at the end of the work day less worried that they didn’t have enough time with patients or that they would need to spend the evening manually handling onsite servers and files, as so many doctors do.
Or Watauga Orthopaedics, a smaller surgical center in the south that was having trouble managing the growing number of high-deductible health insurance plans. With cloud connectivity doing the dirty work of reaching out to payers, Watauga can present patients with real-time cost worksheets that break down their insurance plan, benefits, and what out-of-pocket costs for a particular procedure will look like in advance. Ultimately, Watauga has decreased its insurance denial rate from 17 to 20 percent, to 3 percent, increased patient walk-ins from 200 per month to 750 per month, and reallocated employees previously burdened by this work to be more patient-facing roles.
There is so much good that new-age platform companies have brought to other service industries: for example Amazon’s assortment and delivery of household goods, Lyft’s ability to streamline travel from point A to point Z, and LinkedIn’s aptitude for identifying influencers and delivering their insights to your inbox. Imagine what good such automation of knowledge could bring to healthcare, the industry that most needs a seamless flow of information yet falls the furthest behind. We could make the United States much healthier, which is what we all want.
Kyle Armbrester is Senior Vice President and Chief Product Officer of athenahealth. He oversees the product management and service organizations for the company’s core services, athenaOne.