Healthcare organizations continue to face ongoing challenges related to clinician turnover – driven in large part by burnout and dissatisfaction with electronic health records.
Beyond that human toll, the financial repercussions of turnover are substantial for healthcare organizations. The average cost of replacing a nurse is approximately $56,300, as shown in a recent report on the topic from KLAS, while the expense for replacing a physician can vary between $500,000 and $1 million.
Sandra Johnson is senior vice president of client services at electronic health record, revenue cycle management and analytics vendor CliniComp. We asked her recently about the essential criteria that providers should consider when assessing EHRs for their potential to cause burnout. She highlighted, among other insights, the key importance of systems that are designed by practicing clinicians.
Q. Nearly two decades since they’ve become ubiquitous in healthcare, why are electronic health records still contributing to clinician burnout? What is happening for a piece of technology to drive so many providers out of their jobs?
A. Electronic health records contribute to clinician burnout through multiple interconnected factors, with design and usability issues being primary concerns. Many EHR systems are not intuitive, which increases cognitive load and frustration among healthcare providers.
The extensive documentation requirements, while necessary for compliance and billing, result in clinicians spending more time on administrative tasks than actual patient care. This fundamental shift away from their core mission of helping patients is a significant source of job dissatisfaction.
The technology often forces clinicians to focus more on screen time than patient interaction, creating a disconnection in the doctor/patient relationship. Additionally, clinicians frequently face “alert fatigue” from excessive system notifications, and the lack of interoperability between different EHR systems leads to duplicate documentation and constant toggling between multiple platforms.
These issues compound the administrative burden and further reduce time available for patient care.
Much of this stems from EHRs’ original development as billing systems rather than clinical workflow tools. While documentation and billing requirements are necessary, the systems weren’t initially designed with clinical workflows in mind.
This misalignment between technology and practical needs has created a situation where clinicians – who entered healthcare to help patients and create meaningful impact – find themselves spending excessive time managing technology and doing endless administrative tasks instead of providing care.
Q. What are the financial implications of clinician turnover for healthcare provider organizations?
A. The financial impact of clinician turnover on healthcare organizations can be substantial and multifaceted. The most immediate costs come from recruiting and training new hires, which requires significant monetary investment as well as considerable time and resources to properly train and upskill incoming staff.
These expenses extend beyond just hiring costs to include the resources needed to provide comprehensive training programs.
Organizations may anticipate significant productivity losses during the transition period. New hires require time to acclimate to their roles and learn the EHR system, during which they operate at reduced efficiency.
Additionally, the productivity of existing staff is affected as they must dedicate time to training new colleagues while maintaining their own patient care responsibilities. This dual impact on productivity can have substantial financial implications for the organization.
Beyond these direct costs, high turnover rates can negatively impact quality of care and patient experience. When experienced clinicians who work well together leave, it can disrupt established care patterns and affect quality measures.
Patient satisfaction may decline if there is frequent turnover, as it can erode trust and continuity of care. These factors can ultimately affect an organization’s reputation and financial performance through reduced patient retention and potential impacts on quality-based reimbursements.
Q. For clinicians who initially considered leaving but ultimately chose to remain, a reduction in burnout emerged as the primary reason for their decision, according to KLAS. The second most influential factor was improved training in the use of electronic health records. Please elaborate on these two factors.
A. Reduction in burnout and improved EHR training represent crucial factors in clinician retention, particularly when organizations invest in technology that can quickly be implemented, seamlessly upgraded, and automates workflows and reduces administrative burden.
When healthcare organizations demonstrate a commitment to addressing burnout through technology and process improvements, it shows clinicians their concerns are being heard and addressed, which can significantly influence their decision to stay.
The training aspect goes well beyond basic system navigation and implementation. Effective EHR training programs focus on ongoing optimization and workflow improvements, helping clinicians discover efficiency-boosting features and shortcuts that can streamline their daily tasks.
This continuous education approach ensures clinicians stay current with system updates and learn to leverage new features that can improve their workflow efficiency.
What makes these training programs particularly effective is their focus on specialty-specific workflows rather than generic system use. By tailoring training to individual specialties and specific clinical needs, organizations help clinicians maximize the system’s potential in their particular area of practice.
This specialized approach, combined with continuous investment in optimization and workflow improvement, helps create an environment where clinicians feel supported and equipped to provide efficient patient care while managing their administrative responsibilities.
Q. What are essential criteria healthcare providers should consider to avoid burnout when assessing electronic health record systems?
A. When evaluating EHR systems to minimize burnout risk, usability emerges as the primary consideration. An intuitive, user-friendly interface that aligns with clinical workflows is crucial for reducing the time and effort required to learn and use the system effectively.
This must be coupled with strong interoperability capabilities that allow seamless integration with other systems and devices, thereby reducing redundant charting and facilitating efficient information exchange.
Customization capabilities represent another critical factor, as the system should be adaptable to both specialty-specific needs and individual user preferences. This flexibility should be supported by robust, ongoing training programs that ensure users can effectively use the system and adapt to new features over time.
Additionally, the system should incorporate feedback mechanisms that allow clinicians to contribute to its evolution, ensuring updates and improvements address real-world clinical needs.
System reliability and performance cannot be overlooked, as downtime and technical issues can significantly impact both patient care and clinician satisfaction. Modern EHR systems also should leverage artificial intelligence and automation to reduce administrative burdens, particularly for routine tasks.
The ideal system should demonstrate a commitment to continuous innovation, with regular updates and improvements that respond to user feedback and evolving healthcare needs, while maintaining strong performance and reliability that clinicians can depend on.
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