Burnout among healthcare staff continues to be a challenge. “Emotional exhaustion, elements of depersonalisation and feelings of reduced personal accomplishment … [often leading to] negative effects on patient care, increased errors, decreased self-worth and care,” said Charles Alessi, chief clinical officer at HIMSS, as he described the feeling and impact of burnout on healthcare professionals, during a roundtable session I was fortunate enough to be involved in at the HIMSS & Health 2.0 European Digital Conference.
Helen Gyves, Chief Nursing Informatics Officer at the University Hospitals Birmingham NHS Foundation Trust followed this up with an impassioned description of the “fear” that’s exacerbating the effects of burnout for clinicians, as well as the burden of expectation that rests upon their shoulders each day: “Fear for themselves because this is all very unknown – new job, new role, new world they’re working in – fear for the welfare of their patients, fear that they’ll make a mistake,” she said. “Staff are expected to get on with it, do it in a knowledgeable, confident and caring way… they’re expected to manage the elective work. They’re expected to deal with the emergencies. They’re expected to keep it all within budget.”
These expectations were difficult enough to meet before the COVID-19 crisis – and a key challenge that’s been ever-present in being able to deliver on the expectations of patients is of course time. Combined with the very necessary requirement of clinical documentation, time is severely limited when it comes to treating patients. According to a survey by the University of Belfast, 47 percent of doctors stated too many bureaucratic tasks (such as note keeping and paperwork) contributed to burnout. When, in addition to creating notes, you include the time spent searching for information, reviewing that information, and often duplicating the data entry, it’s estimated that over 50 percent of a clinician’s time can be spent on clinical documentation – which means they’re spending around just 13 percent of their time interacting with patients.
Engaging staff in technology deployments to address burnout
The Charité Hospital in Berlin is one of Europe’s largest university hospitals and, like many others, accelerated its digital transformation initiatives due to COVID-19. Felix Balzer, Chief Medical Information Officer at Charité discussed how it is critical the right technology is deployed to support staff. Emphasising the role of engagement with clinicians as part of any IT rollout, he went on to say that education is critical. “After all, clinicians are trained to work with patients, not computers.”
Fredrik Jonsson, Chief Medical Information Officer, for the Region Skåne in Sweden echoed this, “When we configure deployments, we have a very high level of physician and nurse involvement… 70 percent of those involved in deployment are clinicians and nurses,” he said. “If I had to choose one particular aspect on how to improve clinical software, this would be to include clinicians in the development and the implementation of the software from the very beginning.”
An intelligent future
Jonsson went on to say his team is looking into the adoption of Artificial Intelligence (AI) to move clinician engagement from the desktop toward a more holistic model – improving the quality of data, as well as tackling burnout.
I certainly agree with this approach and believe AI is already playing an important role in reducing administrative burdens on day-to-day activity. We see AI engagement going deeper as we move into the future – with clinic rooms of tomorrow deploying what we call ambient clinical intelligence (ACI). Innovated by Nuance and Microsoft, the Nuance ACI solution, called Dragon Ambient eXperience (DAX), is built on decades of healthcare experience, in-depth research investments in conversational AI, and enterprise-focused cloud services. Nuance DAX leverages and extends the proven power of Nuance Dragon Medical, already relied upon by over 550,000 physicians globally, with the latest advancements in ambient sensing technology and AI to create a fully voice-enabled and ambient clinic room environment. This allows physicians to focus on the patient while the AI securely captures the details of the virtual visit in context – creating clinical documentation that writes itself. This technology was recently released in the U.S. and is already changing the way we deliver healthcare.
Thank you to HIMSS for allowing me to take part in this session, and you may view the entire recorded discussion here in case you missed it.