According to a JAMA Network Open Study, there are parallels between workflow and the usability of an IME transcription inbox, and efficiency, safety, and physician burnout.
Research has indicated that doctors want healthcare organizations and EHR developers to reduce the complexity of message processing, streamline inbox interfaces, include features that will reduce the cognitive load that’s placed on physicians daily, expedite communication with care teams, and simplify inbox messages.
Six large healthcare companies underwent research via walkthroughs. Four different IME transcription systems were used among 25 physicians between 2015 and 2016.
During the interviews, doctors identified 32 facilitators and 50 barriers associated with EHR workflows and inbox designs. Their preferred method is streamlined messaging which would result in fewer clicks.
One physician still believes it will be too many clicks, considering the amount of messages providers can have throughout the day. Some of the interfaces were organized and clean while others were quite disorganized. This is what physicians believe may be the reason behind the complicated inbox categories.
Another physician noted how many different categories there were in the interface he works with, including letter queue, which is hardly ever used. He doesn’t even know what it’s for, nor does he even use the patient questionnaire feature which is irrelevant to his work.
Complicated medical transcription inboxes can overload a physician’s already hectic workday. A more helpful feature might include adding flags or comments to remind them, which some systems actually had. Of course, those systems received positive feedback.
It’s hard to remember so many different things, which is why physicians who couldn’t set reminders experienced overload. Some of the participants of this study recommended adding to-do lists to the EHRs. They also expressed coming up with a better way to allocate tasks to the clinical team so that communication could be improved amongst the staff.
One physician wishes that patient messages could be triaged by their staff so that less important issues wouldn’t have to be addressed on their end.
Moreover, participants addressed duplicate messages as well as messages that are deemed low-value, as they take up extra space in their inboxes and decrease overall efficiency because they have no direct effect on patient care. In order to improve efficiency and safety and reduce burnout among physicians, a joint effort between healthcare organizations and EHR creators would need to take place.
Researchers noted that the usability of a medical transcription inbox is variable and suboptimal across different sites, which suggests that best practices regarding information management are severely lacking.
Developing national or regional conglomerates to support the implementation of an EHR system, as well as collaborative sharing across healthcare organizations and EHR creators, could improve efficiency and safety and diminish physician burnout.
There have been numerous studies that have linked EHRs to physician burnout. Additional data from the University of New Mexico showed that over 40% of burnout was related directly to EHRs.
Providers attended college to take care of patients. However, for every two extra minutes they are spending on a computer, they are spending less time with patients, according to Philip Kroth, MD, who directs the Biomedical Informatics Research department at the University of New Mexico. He’s also noticed a sharp increase in the amount of hours physicians are expected to work (60 hours a week) in order to keep up with the documentation alone, which makes it tough for them to be able to manage their personal lives with their families and close friends.
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