A white paper from the Ontario Medical Association (@OntariosDoctors) produced by a task force on physician burnout is one of the first in Canada to deal explicitly with the toll on physicians from practicing in a digital environment and identifying potential solutions.
A number of studies and policy documents from the US over the last few years have documented how use of electronic medical records (EMRs) and hospital point-of-care systems have contributed to physician burnout due the requirements for additional documentation and record-keeping.
While similar concerns have been voiced in Canada, country-specific data has been lacking, as have advocacy initiatives and proposals to address the issue.
“Healing the Healers: System-Level Solutions to Physician Burnout White Paper” deals with the issue head-on. One of its five recommendations for addressing physician burnout calls specifically for seamlessly integrating digital health tools into physician workflows. The first recommendation from the report concerning documentation and administrative work also addresses the burden placed on physicians by EMRs and hospital administration systems.
Chaired by physician health expert Dr. Mamta Gautam (@PEAKMD), the task force that prepared the document references the finding that physicians spend two hours on electronic documentation for every one hour of direct patient interaction.
To address this issue, the task force identifies the use of medical scribes as a means of relieving the burden on physicians by having someone else document patient encounters in real time. However, the task force notes that significant additional expense is involved with this approach and states that individual physicians should not have to pay for this means of reducing their incidence of burnout. The report goes on to note that “virtual scribes” or AI scribes might provide innovative solutions at a lower cost.
Finally, the task force discusses simplifying the multiple log-on process required for physicians to access a number of different systems as an effective way of saving a significant amount of time and frustration.
On the specific recommendation of integrating digital tools into physician workflow, the task force states this is essential to reduce the stress for physicians associated with using EMRs and other digital systems. More specifically the report recommends “implementing interoperability standards to ensure physicians can seamlessly access patient records and share patient health information among care providers.”
Another recommendation which hearkens back to the very start of the EMR era calls for physicians to be key partners from the start in the procurement, design, implementation, and ongoing optimization of digital health tools to ensure usability.
A third recommendation in this section dealing with change management, which had been a key tenet of the best physician EMR implementation programs in Canada in the 1990s and 2000s, is to “equip physicians with comprehensive and ongoing training on digital health tools.”