Physician Burnout! A disturbing trend

Burnout1

Since my last post about my late Grandfather, I didn’t have the motivation to write; but then I thought about all of the times he encouraged me to write, it reminded me to follow my passion, so here I am with my thoughts again, this time on the disturbing trend of Physician Burnout.

Physician BurnoutOver the last 7 years since the time of the “Great EMR Implementations”, we have always discussed physicians retiring because they did not want to learn technology and use the EMR. I put it down to older physicians not keeping up with the times. I’m not so sure about that anymore.  The reason being that one of my friends who is a physician went through a very visible burnout episode that surprised everyone recently. She said that she was working until the middle of the night trying to keep up with documentation and it finally became too overwhelming for her to take. This surprised me tremendously. This wasn’t something that happened to younger, more savvier physicians…or so I thought. IBurnout2n a June 29th, 2017 article in the Harvard Business Review, points such as loneliness at work is also a factor that is identified as the reason for burnout (it doesn’t discuss physician burnout in particular though). Similarly, in a June 22nd article in Time Magazine, titled “Doctor’s on Life Support”, it starts by saying that “Doctors are stressed, burned out, depressed, and when they suffer, so do their patients. Inside the movement to save the mental health of America’s doctors“. The  signs of stress are evident. IT departments can and should do more to collaborate with clinic practices and primary care and specialties to help develop efficiency within the every day use of technology. Technology “A-Teams” should be identified to work with their physicians, understand the challenges that they are facing, whether in the EMR, wireless “dead zones” in clinics that drop the connection, old laptops and PCs that need to be updated, that sometimes may mistakenly be attributed to an EMR deficiency or other areas where the process can be smoother for the physician and/or clinic staff.

All of us as Healthcare Information Technology professionals needs to bear in mind that we need to do all we can do reduce and eliminate physician burnout and improve the processes for the physician so that we can enable them use technology for better, faster and more efficient patient care. The burden of EMR documentation should be lessened and, at the end of the day, it will be the patient that will gain and the quality of care will increase with a happier, less stressed, care provider.

 

The American Health Care Act 2017

I was chatting with my colleague Scott Mash from the CSO HIMSS Board on the way to work this morning and we were talking about how all of the successes we have had over the last 5 to 6 years on improving interoperability across the healthcare landscape in the United States and Meaningful Use could all be in jeopardy with the new healthcare law currently being proposed by The White House and to be voted on in Congress this week. The American Health Care Act in consideration will have a direct impact on the lives of all of the patient population across the healthcare spectrum. Healthcare providers across the United States are strongly lobbying that the proposal be changed and significantly improved so that it can protect health care access for many individuals nationwide.

The proposed act puts the healthcare benefits of around 14 million individuals, that depend on Medicaid for health coverage into ambiguity; a tentative roll-back of Medicaid expansion in several states and differences in how the US government will assist the states to pay for Medicaid, will mean that each state may have to bear the brunt of these cut backs with potentially less federal subsidies coming in. This means that states such as my state, “The Great State of Ohio” will have to reduce payment rates, patient eligibility or patient benefits in order to cover the shortfall.In addition to Medicaid coverage losses, employer coverage could fall by as much as 7 million. Patients who might have otherwise had employer-sponsored insurance would transition to the individual market or become uninsured.

Beyond the increase in the self-pay patient population, many individuals may have extremely high deductibles that would make their healthcare insurance coverage unaffordable to them. This information is going out to many within healthcare providers. I was able to get some of the information for this blog post from other people that I know and do not claim to be the originator of this blog post information.

While there is no silver bullet to achieve healthcare benefits for all, the answer is not to roll back the successes we have seen over the last decade; the opportunity for us now is to build on the achievements we have made and improve how we can achieve better patient outcomes for all. Let’s continue to improve and not roll the clocks back.  

PS – The inspiration for this blog post was when Scott and I ended the call with “Holy Toledo! To the Blog Cave Batman!”

 

HIMSS ’17 Updates Regulatory Reluctance & Inspiration from Rometty

News from on the ground at HIMSS 17 is that the current tone coming from the regulatory and policy sessions has been one of  reluctance in discussing potential changes possible my due to the ambiguity  due to new administration”

Ginni Rometty the Opening Keynote speaker also spoke to the audience and was received enthusiastically from the news on the ground folks. Healthcare IT News said that Rometty said that the ‘cognitive era is a profoundly hopeful moment in time’ and also announced solutions for value based care and Watson Health Consulting Services. She also reportedly mentioned projects that was ongoing with the Cleveland Clinic and Memorial Sloan Kettering to advance ‘cognitive computing’ per Healthcare IT  News. 

More from Healthcare Interoperability’s roving reporters on the ground! Thanks all. 

2016 – The year of Disruptive Living

With 2016 behind us, it’s hard to believe we somehow survived this year. Whether we admit it or not, we’re not used to big changes and politics does play an important part of our lives. Whether it’s in that realm or in technology, we are creatures of habit and rarely like our world or ecosystem to change. The biggest challenge I’ve always encountered on a project is change; whether it’s process or technology changes, it’s always a challenge to get people to change and adopt a new way of working. Physicians are particularly challenging to change as they are very set in their ways.

Whether it’s the elections that occurred that seemingly swung the pendulum a different direction than what was in motion for the last 24 years or the endless march of technology like Amazon Go, (which I believe could have applications outside of Retail such as in Healthcare), our lives have been greatly disrupted as we see that the status quo is not acceptable anymore.

I’ve been asked by a few people whether MACRA will get scrapped under the new US administration or whether some of the current other reporting requirements will be changed. Currently the view has been only time will tell as there has been no specific policy that has mentioned anything one way or another. Will much of the work accomplished or investment over the last 5 years be set aside or will we be able to build off that and leverage this paradigm shift for the greater good?

Only time will tell. Whatever it is, there are many people that would like to see 2016 into a distant memory and hope that the new year brings with it better fortunes than the current one has dealt many.

In Memorium: Carrie Fisher aka Princess Leia (1956 to 2016)

“Help me Obi-Wan Kenobi, you’re my only hope.”

Are EHR vendors becoming Population Health corporations?

An interesting article surfaced in Healthcare IT News that suggested that executives at some healthcare software vendors want to transform themselves from generically being deemed as an EHR vendor and become a Population Health company like Cerner’s CEO Zane Burke told Healthcare IT News. 

Being able to access data relevant for patient care should be possible regardless of the format it is presently in or whether it is in an EHR,  national database or in pdf format. 
The constraints that “EHRs” are presently may not allow for this functionality  (yet). The article goes on to state that providers are also moving towards precision medicine, accountable care management, chronic care management and value based reimbursement. 
Movement for many on the ground is still in the initial stages and only those provider organizations with deep pockets and the ability to leverage collaborative working relationships with solution vendors can think about moving forward with all of the initiatives mentioned above in a meaningful way. 

Truly Epic! R&D Spending sensation 


In a story published on September 13th , 2016 by Healthcare IT News (HIT News), Epic Systems’ founder Judy Faulkner  ( just ‘ Judy’ to many in the Healthcare IT world) revealed that Epic invested something like 50% of its operating expenses on research and development, outstripping all organization in and out of the Healthcare IT ecosystem. 

HIT News verified through federal filings that Cerner spent 19%, Allscripts spent 34% and athrnahealth was at 10%. Google spent 45% of its operating expenses on R&D  (or $12 billion) and seemed to be the closest when it came to a percentage of operating budget. 

The thought that ran through my mind was ” Has this translated to better and more efficient and streamlined patient care at Epic’s customers versus provider organizations that have implemented a competing product? I’m all for R&D and believe that it’s really what makes America great  (I don’t think we’ve lost the ‘greatness’ since 1776 when the Founding Fathers declared independence, but that’s another story for another day). The technology of the 21st century has indeed been spurred by American innovation and ingenuity  (Facebook,  Twitter and the entire world of Social Media). R&D brings us medicines that have been life changing to many and previously were inconceivable even in the latter part of the 20th century, but with the cost of patient care rising and many Americans wondering how to get them within reasonable limits anymore, does this only add to our costs in the patient community or will it be the savior of millions and have a lasting impact for the country and the world. Makes you think. …