Clinician Burnout in the EHR era Christopher A. Longhurst, MD, MS - - PowerPoint PPT Presentation
Clinician Burnout in the EHR era Christopher A. Longhurst, MD, MS CIO and Associate CMO, UC San Diego Health Clinical Professor of Medicine and Pediatrics @calonghurst Mike South, MBBS, PhD CMIO and Paediatrician , Royal Childrens Hospital
Christopher A. Longhurst, MD, MS CIO and Associate CMO, UC San Diego Health Clinical Professor of Medicine and Pediatrics @calonghurst Mike South, MBBS, PhD CMIO and Paediatrician, Royal Children’s Hospital Professor of Paediatrics, Melbourne University @mikesouthRCH
Population Health Patient Experience High Value Care Caregiver Experience
The Triple Aim: Care, Health, and Costs, Health Affairs, 2008 From Triple to Quadruple Aim, Family Medicine, 2014
UCSF UC Davis UCLA UC Irvine UC San Diego
“A psychological syndrome in response to chronic stressors on the job -
feelings of cynicism and detachment from the job; a sense of ineffectiveness; lack of accomplishment or fulfillment.”
Abraham Verghese, New York Times Magazine, May 16, 2018
UC San Diego Health medical staff surveyed in September 2017 @KLASresearch #ArchCollaborative
San Diego
VA San Diego Healthcare System Rady Children’s Hospital
Imperial Valley
El Centro Regional Medical Center
Southwest Riverside
Inland Valley Medical Center Rancho Springs Medical Center Temecula Valley Hospital
North County
Tri-City Healthcare District
Coachella Valley
Eisenhower Medical Center UC San Diego Health Campus UC San Diego Health Clinic(s) Affiliate Hospital Affiliate Medical Group Clinic
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UC San Diego Health led by informatics team
UC San Diego Health led by ambulatory operations
functioning at the top of their license
Where we have IS medical directors, we tend to have high provider ratings on EMR experience UC San Diego Health KLAS EMR Experience Survey – September 2017 @KLASresearch #ArchCollaborative
Key opportunity identified from survey: Half of UCSD medical staff rated themselves as low efficiency for outpatient charting @KLASresearch #ArchCollaborative
“I need my entire group to do this, it was amazingly helpful. I have used EPIC for a long time and I am terribly set in my ways but set up ways to help with less jumping around.” *100% would recommend to a colleague
Reduced by up to 75% for half
1 2 3 4 5 Comfort with workflows Ability to use knowledge
Before and after surveys
Before After
User feedback physician surveys After hours time report for physicians
2018 goals:
Collaborative
patient
videos for training
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paperwork” initiative “At CMS, our top priority is putting patients first. CMS Administrator Seema Verma launched the “Patients over Paperwork” initiative, which is in accord with President Trump’s Executive Order that directs federal agencies to “cut the red tape” to reduce burdensome regulations. Through “Patients over Paperwork,”
reduce unnecessary burden, to increase efficiencies, and to improve the beneficiary
regulatory obstacles that get in the way of providers spending time with patients.”
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Hospital units still on paper: None Departmental CISs: Retired
@KLASresearch #ArchCollaborative
@KLASresearch #ArchCollaborative
USA RCH Problem: Abdominal pain The problem has been getting worse. The pain is in the Right Lower
severity level of 8/10. The quality of the pain is sharp. Associated symptoms currently include fever
USA RCH Problem: Abdominal pain The problem has been getting worse. The pain is in the Right Lower
severity level of 8/10. The quality of the pain is sharp. Associated symptoms currently include fever Abdo pain
We actively encourage this style Note-writing tools reconfigured
Transcription into notes Scribes Voice recognition Copy Forward
USA - Documentation driven by something other than clinical care?
At RCH – no staff other than clinicians look at the outpatient
view. There are no drivers for clinicians to document anything other than what is needed for good clinical care
Many non-clinicians are reviewing the notes There are strong drivers for clinicians to document +++
Population Health Patient Experience High Value Care Caregiver Experience
The Triple Aim: Care, Health, and Costs, Health Affairs, 2008 From Triple to Quadruple Aim, Family Medicine, 2014
Mike.South@rch.org.au @mikesouthRCH clonghurst@ucsd.edu @calonghurst