Clinician burnout is an IT leader’s concern
After years of navigating the many and varied challenges of the COVID-19 pandemic, clinicians are burned out. If you work in health care, you already know this and have read articles detailing just how dire the situation is. And while clinician burnout is undoubtedly a top priority for a Chief Medical Officer or Chief Nursing Officer, we don’t often read or hear about this challenge from the perspective of the Information Technology (IT) healthcare leader (e.g., CIO, CMIO, CNIO).
But clinician burnout is undoubtedly an IT concern.
The abundance of technological solutions related to Electronic Medical Record use, clinician decision support, telehealth, and the overall increase in digital health offerings has meant a continual stream of new applications to learn, changes to clinician workflows, and additional administrative tasks. While any individual change may be insignificant (and also come with benefits), the continual stream and totality of changes are overwhelming. As a result, clinician cognitive overload related to tech usage is significant.
And the clear consensus is that administrative burden is the single largest contributor to clinician burnout.
As health systems scramble to attract, hire, and retain talent, they need to focus on ways to enable clinicians to do more of what they love—care for patients. IT is an underleveraged area to do so. IT leadership agrees that technology must be a core component of addressing today’s workforce challenges, including finding ways to support top-of-license practice and increase care team efficiency. If leaders can identify ways to do this with health system technology, it will undoubtedly begin to reverse the trend of clinician burnout.
And we know that reducing burnout benefits everyone. It improves clinician satisfaction, helps retain staff, improves patient outcomes, and increases patient satisfaction.
Care team administrative burden is now a top 3 CIO priority
The time to act is now.
Overall, health systems are expressing a widespread commitment to elevate their IT strategy and specifically focus on digital transformation. Leading Health Systems (LHS) are increasingly viewing technology as a key organizational pillar, alongside areas like clinical care and patient education. And to demonstrate the importance of this strategic commitment, some systems plan to significantly increase their spend on IT across the next few years.
But until recently, efforts to modernize and streamline clinician workflows did not rise to the top of the list of competing IT priorities. In the age of digital transformation, a multitude of priorities—including improving virtual care, information security, data and analytics, and cyberthreat response, among others—fall under the purview of the IT executive. With such a broad range of important and urgent issues, IT leaders have understandably deprioritized efforts to streamline clinician workflows. But effective IT workflows underlie a health system’s ability to optimize all tech-driven priorities, and the inefficiencies that contribute to clinician burnout have ripple effects across the organization.
The good news is that as the link between current technology use and clinician burnout has become increasingly clear, CIOs have shifted their sights to tackle clinician workflows, particularly through the lens of administrative burden. In the 2022 Academy Priorities Survey, CIOs ranked “developing tech-enabled solutions to reduce care team administrative burden” among their Top 5 priorities. And for 2023 it ranks as a top 3 priority, alongside implementing practices to improve information security and improving cyberthreat incidence response and recovery planning. In this, we see that the extremely high organizational cost—in time, money, and reputation—of events such as a ransomware attack or data breach are on par with the costs of tech-related workforce burden.
But how are CIOs planning to address the costly day to day administrative and workflow burden for their care teams?
Modernizing tech solutions is primarily a task of strategic consolidation
During the pandemic, health systems raced to put in place numerous clinician and consumer-facing platforms for a variety of tech-related issues. Individual teams, leaders, and sites of care were often given tremendous autonomy to procure, purchase, install, or implement what was needed to continue caring for patients. This unquestionably brought rapid and abundant technological innovation into health systems.
However, with such a fast pace of change, it was (and is) often difficult to coordinate across the organization and bring awareness to existing solutions that are working and could be scaled more broadly. Systems now use dozens of apps with point solutions and a patchwork of integrations to enable everything to work together. The result is a fragmented digital ecosystem that often hinders the clinical workflow optimization health systems say they are seeking.
“We have too much tech and they’re either redundant or don’t meet our needs.”
– IT Leader, Leading Health System
Health systems are now tasking their IT leadership with building out a more strategic approach. Many technology leaders state that they are working toward a strategic roadmap of solutions that improve efficiency, reduce redundancies, and manage costs. Yet while LHS agree they need solutions to improve integration and facilitate seamless care, many are still early in their journey. The work ahead is to streamline, consolidate, and focus on tools that clinicians most value.
To this end, several LHS are performing full system audits to consolidate and restructure their tech investments. While in principle many systems would prefer one platform or partner to meet multiple needs, they report difficulty identifying partners that meet a variety of needs without extensive customization. CIOs often feel they must trade off between choosing a single platform that meets most needs and multiple platforms that meet all needs. Partners must recognize this tension; those with more comprehensive solutions and offerings are likely to have a market advantage.
An updated IT governance structure should undergird strategy
The CIO role previously emphasized the ability to attract, hire, and retain talent. But as organizational needs have shifted to increasingly necessitate CIO contribution to system-wide strategy, the role has evolved. Alongside this trend, we also see a proliferation of IT-related C-level roles and titles (e.g., CMIO, CNIO, CDO, CISO, CAO, and CTO) to address new technological challenges and opportunities. While any individual role might make sense for a system’s unique needs, when taken as a whole, systems are struggling to define who is accountable for what. Accordingly, the issue of streamlining clinician workflows might seem like a challenge that multiple IT leaders could address. As a result, all too often no one feels accountable to address it.
But inevitably, governance and accountability structures impact decision-making, which then influences stakeholder engagement when it comes to workflows and operationalizing new investments. It’s therefore more important than ever to clarify which IT leaders are responsible for which decisions, and who has seats at which leadership tables. Health systems recognize how essential good governance is, and it is important to continue updating structures and processes in this rapidly evolving area of leadership.
Engaging the care team in the process facilitates greater success
All too often health system executive strategy is well-intentioned in principle yet disconnected from clinical operations in practice. While it is relatively common to involve multidisciplinary teams in developing clinical pathways or purchasing a new piece of equipment, it’s less common to do so with technology workflows and applications. This results in digital strategies—and specific solutions and workflows—that are not fully aligned with current system capabilities or providers’ preferences. Further, given the challenges many LHS have faced with prior tech rollouts, it’s increasingly difficult to achieve clinician buy-in for new solutions.
“When we do things with technology, we don’t often engage multidisciplinary teams. Then you get this reaction of ‘we built it, why won’t they come?’” – CMIO, Leading Health System
This needs to change.
LHS who are doing this well consistently highlight a few best practices. First, they seek out and incorporate clinical leadership and clinician perspectives as they set overall digital strategy and define decision-making processes. This inclusive style of engagement facilitates more successful adoption and implementation of individual digital tools down the road.
Then they work to consult clinical staff and administrative teams in the design, piloting, and/or testing of applications, processes, and workflows. Yes, every step of the way, as it is often the smaller details that can undo a thoughtfully laid out strategy. Anything that requires additional learning time, more clicks in a workflow, or new processes is often (and reasonably) met with resistance. Identifying and addressing these issues earlier increases the likelihood of adoption.
And finally, successful systems don’t stop engagement with the initial rollout but also continue to involve a multidisciplinary team over time. Additional clinical input is needed when scaling technology solutions across the organization.
Engaging a multidisciplinary care team at every step of the process sounds simple in theory but is undoubtedly challenging in practice. Yet garnering buy-in is an essential part of the work to effectively modernize clinical workflows.
While securing care team feedback solves much of the equation, IT leaders also need to be mindful of the impacts of tech solutions on another key stakeholder: patients.
Optimizing tools for both clinicians and patients further elevates workflows
LHS increasingly recognize they need a robust digital health strategy that responds to consumer demands and enables them to remain competitive as disruptors continue to enter the space. But it can be difficult for systems to do this in a way that is both integrated into the system’s network and easy for patients to navigate.
Yet the fact remains—IT leaders need to create digital solutions that meet the needs of clinicians as well as patients.
Patient-facing solutions need to be intuitive, interoperable, and seamlessly integrated across provider settings. Patients expect this out of their digital engagement with health systems. Partners who can optimize solutions for care team workflows and patient engagement will have a clear advantage over their competitors.
Considering each patient-facing app or digital touchpoint from the perspective of the patient should be an integral step in systemwide audits of technology solutions, and a non-negotiable in assessing vendor capabilities.
The Academy extends its appreciation to Wolters Kluwer for their sponsorship of this article.