Physician burnout is caused by multiple factors, one of which is clinicians’ increasing responsibility for data collection. The EHR system alone is not entirely at fault.
The increase in clinician data collection responsibility has myriad causes, including: healthcare laws that are requiring more documentation; billing and reimbursement that is more complicated; cost and quality being more carefully scrutinized; and communication between healthcare team members that has become increasingly electronic. Reducing clinician EHR burden must therefore be approached from different angles. One method of reducing the burden is shifting more of the data-entry responsibility to other members of the healthcare team. This is often referred to as “team documentation.”
Team documentation, as envisioned by the American Medical Association in its StepsForward Module on Team Documentation, can be the equivalent of using scribes. (Using scribes to reduce burnout is addressed here.) It alternatively can be a planned aspect of clinical care model redesign. Team-based care can refocus clinician time and effort on patient care and move some of the data-entry burden to other members of the healthcare team.
Listed below are articles and other resources that discuss redesigning the clinical care model to address increased clerical burden leading to clinician burnout. These “team care” models propose delegating additional duties to nurses and medical assistants to relieve physician burnout. Although delegation of duties to a medical assistant or nurse can reduce clerical burden, clinicians must ensure duties being delegated are within the scope of care and licensure requirements of the staff (if applicable). Staff should never be tasked with a duty that results in their practicing medicine without a license.
AMA Steps Forward Module on Implementing Team-Based Care
This electronic tool kit provides guidance on utilizing a physician-led, team-based care approach to increase efficiency and productivity.
AMA StepsForward Module on Team Documentation
This electronic tool kit is organized around eight steps to help medical practices select a scribe model, train staff and continue to evolve the team documentation approach.
Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations
This article discusses a recent study conducted at the University of Wisconsin-Madison Department of Family Medicine and Community Health in southern Wisconsin, which utilized Epic EHR system event logs to evaluate clinician workload, and then created a framework for reducing burnout associated with clerical burden.
Beyond Burnout — Redesigning Care to Restore Meaning and Sanity for Physicians
This article describes a significant drop in burnout rates following implementation of a clinical care model redesign at the Department of Family Medicine at the University of Colorado, which they call APEX (Ambulatory Process Excellence).