With growing pressures and backlogs in healthcare amid the repeated waves of the pandemic, hospitals and health systems are now strongly considering whether telehealth is the solution our healthcare providers need to alleviate provider burnout and enhance healthcare efficiency to achieve the Quadruple Aim.
A common metaphor for understanding provider burnout is the battery. Providers often describe the state of being burnt out as “my batteries are running low.” However, this is different from reality. When a toy’s battery runs out, it stops working. But when do healthcare providers stop working? The answer is likely “never.” Healthcare providers work tirelessly to achieve the three “A’s” of physician excellence – to be able, affable, and available in any circumstances, especially during a global pandemic.
Overnight, the pandemic upended our lives and changed how we work, learn, and interact as social distancing guidelines led to a more virtual existence. As it appears to be winding down, we are ready to put it in the rear-view mirror and accept it as the ‘new normal’ which changed our daily lives, including how and where we work.
But it’s not the same for healthcare workers. A sense of shared purpose marked the beginning of the pandemic as healthcare providers joined forces to stem the tide of COVID-19. However, as the pandemic expanded and lingered, healthcare systems are facing a mass exodus. Since February 2020, nearly half a million healthcare workers have left the healthcare sector (U.S. Bureau of Labor Statistics). A constant cycle of understaffing, excessive workloads, long hours, and high patient volumes has led to provider burnout.
What is Provider Burnout?
Defined as a long-term stress reaction characterized by depersonalization, the World Health Organization (WHO) recognizes provider burnout as a syndrome affecting most American physicians across all practice settings.
The Three Components Are:
- Emotional exhaustion: leading to easily becoming irritable
- Depersonalization: replacement of usual empathy with cynicism, negativity, and emotional detachment
- Low sense of personal accomplishment: negative self-appraisal, feelings of incompetence, and inefficiency in daily work
Cause and Effect of Provider Burnout
The 2022 Medscape poll reveals that burnout is often associated with increasing administrative tasks, such as filling out insurance and billing forms. Most doctors find that seeking prior authorization and meeting billing documentation requirements is too much of their time.
In RXVantage’s webinar, Practice Excellence: Overcoming Burnout, Cultivating Compassion, and Improving Efficiency to Build a Better Healthcare Practice, Rosemary Laird, MD from ClinCloud Clinical Trials also confirmed this fact and stated that 60 percent of providers believe that too many bureaucratic tasks like charting and paperwork are the most significant cause of their burnout. Other causes also include spending too much time at work, lack of control and autonomy, negative leadership behaviours, lack of social support, limited opportunities to collaborate, and high patient volumes.
The Canadian Medical Protective Association also found that burnt-out providers are more likely to take shortcuts, hastily answer patient queries, discuss treatment options inadequately, and make clinical errors that cannot be attributed to a lack of knowledge. As a result, their patients are less likely to finish treatments, take longer to recover, and show high levels of dissatisfaction.
At your next physician staff meeting, check in with your colleagues because at least one of you is likely experiencing provider burnout. As stated in an article published in the Journal of Internal Medicine, when a provider is burned out and has less time during the day, there are significant impacts on organizational productivity, morale, healthcare costs, and, most importantly – the quality of care.
Telehealth Can Reduce Provider Burnout
While several hospitals and health systems are launching telehealth programs to connect patients to specialists and improve their models of care delivery, they are also uncovering the value of creating better applications of technology to alleviate the burden on providers by automating many tasks that are causing stress in the first place.
Stephen Kalhorn, MD, Professor of Neurosurgery at MUSC, spoke to Becker’s Healthcare about the positive effect of innovation and technology on reducing provider burnout. Kalhorn formed the Zucker Institute of Applied Neurosciences (ZIAN) in 2012 to encourage physicians to discuss new ideas for innovations. To date, the institute reviews around 60 inventions annually, funded 11 technologies, issued 17 patents, and got three inventions FDA approved. Utilizing innovative products and systems offers tired medical providers a chance to break free from their burnout spiral and use their creativity to find solutions to their problems which helps them achieve the end goal – treating as many patients as they can.
Read on to learn how implementing telehealth platforms can help your health system reduce provider burnout:
1. Optimizing Schedules
Juggling patient wait times, appointments, and patients is stressful for providers. In a 2018 Medscape survey on burnout, 35 percent of providers reported that burnout could be reduced through “more manageable work schedules/call hours” and 20 percent thought greater flexibility in work schedules through telehealth could help avoid burnout.
The use of telehealth in care delivery models increases flexibility and convenience, two critical factors driving care decisions for both patients and providers. The convenience of bringing care to wherever your patients are and connecting them with multiple specialists in a single telehealth visit can lead to fewer missed appointments and reduced no-show rates.
Dr. Michelle Alencar, PhD, the Chief Science Officer at inHealth Lifestyle Therapeutics stated in an HCPLive interview that a telehealth visit could be as short as eight minutes compared to an in-person one which can go on to 15 to 20 minutes. Shorter telehealth visits lead to seeing more patients during the day and better time management. With remote specialists handling routine issues remotely, providers at hospitals can make the best use of their work schedules and call hours.
2. Simplifying Long Administrative Tasks with EHR Integration
Referring to the 2022 Medscape poll, an increase in administrative responsibilities was the primary driver of clinical burden as stated by 60 percent of healthcare providers. Integrating a telehealth platform into the EHR and a patient portal can help ease documentation. It automates data entry and eliminates the need to enter the same patient information more than once. Once the telehealth visit is over, multiple specialists can create a summary of the visit and distribute it amongst each other and the patient.
David West, MD, Medical Director of Health Informatics at Nemours Children’s Health explained “an EHR-integrated solution does not require multiple clicks to bounce between documentation and video screens which decreases cognitive workflows and reduces the burden on clinicians.”
In a New England Journal of Medicine (NEJM) article, Hawaii Pacific Health physician Melina Ashton, MD, addressed problems with EHR usability in clinical care. “An increase in administrative tasks has resulted in less time for the activity that clinicians find most important: interacting with patients,” said Ashton.
Ashton and her colleagues at the health system launched the “Get Rid of Stupid Stuff” program to reduce unnecessary administrative burdens. The team was successful in cutting clinical documentation for irrelevant tasks and made the process much easier. For example, the team reduced the number of clicks necessary to document changing diapers for newborns from three clicks to one.
3. Creating Better Patient Experiences
“Patient-centered care” is one of the hottest buzzwords in healthcare right now. However, efforts to decrease physician burnout and improve patient experience remain segregated in different parts of the healthcare system. Based on the article, Correlation of Provider Burnout with Patient Experience, health systems must consider a joint approach between reducing burnout and improving patient experience. Fixing one may fix the other.
But, how does telehealth improve patient experiences?
Health systems always strive to provide patients with on-demand healthcare, but even emergency room visits typically require a waiting period. Patient must wait for some time between their arrival and examination. But now, with the advent of telehealth, health systems are truly providing on-demand health care with just the touch of a finger. Read on to learn how telehealth is improving patient satisfaction.
- Telehealth enables faster care delivery.
The faster a patient receives treatment, the better the results are. But, often, it’s hard for a patient to get on the provider’s schedule immediately. While waiting, conditions worsen, making it more difficult for providers to restore them to their healthy selves.
On the other hand, when patients seek treatment via telehealth, there are fewer barriers to prompt care delivery. Patients reduce their waiting time, which means they can get treatment faster before their ailments worsen. Better patient outcomes lead to higher patient satisfaction levels.
- Virtual care allows providers to make patients a priority.
Nobody likes to feel neglected. When a sick patient comes to the hospital and ends up waiting for hours, they might start to feel they don’t matter, significantly reducing patient satisfaction.
Virtual care visits allow patients to bypass negative waiting room experiences and connect with multiple specialists at once if needed. - Telehealth enhances equitable access to rural areas.
The patient-to-primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people, compared to 53.3 physicians per 100,000 in urban areas, according to National Rural Health Association.
Telehealth bridges the health care divide in rural areas by increasing equitable access to providers. It gives patients an easier way to access doctors and specialists and receive high-quality healthcare to advance the care of chronic diseases.
In the Healthcare IT News article, “Is telemedicine an answer to physician burnout and staffing shortages?,” Dr. Pooja Asyoola, Senior Director of Clinical Operations at Wheel, describes our current clinician staffing shortage as a national crisis, and it’s only expected to get worse. Health systems need exciting new opportunities to motivate their providers, and we must encourage them to explore careers in virtual care. Dr. Pooja says, “Another way for telehealth to help address provider burnout is by powering the transition to what we call “virtual-first care. With virtual-first care, patients can start their journey with telemedicine.”
Achieving the Quadruple Aim of Healthcare with Telehealth
The Quadruple Aim of healthcare – enhancing the patient experience, improving population health, reducing costs, and improving the provider experience is widely accepted as a compass to optimize health system performance. Yet, providers report widespread burnout and dissatisfaction, thus imperilling the Quadruple Aim.
More than ever, experts say the healthcare industry can’t afford to lose highly skilled clinicians to other industries. In an industry plagued by burnout, the adoption of telehealth technology helps clinicians improve workflows by optimizing schedules, simplifying long administrative tasks with EHR integration, and creating better patient experiences. Healthcare providers must aim for “balance, not burnout,” and making telehealth a rule rather than an exception will help achieve that in the long run.
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