I am a huge fan of Dr. Atul Gawande. Who isn’t? He is a surgeon, an author and one of the most insightful and influential physicians of our time. His books are best sellers and his articles in The New Yorker magazine are widely read. He was recently named as CEO of the non-profit-seeking health care venture formed by Amazon, Berkshire Hathaway, and JPMorgan Chase to deliver better outcomes, satisfaction, and cost efficiency in care. He will be the opening keynote speaker at HIMSS19 in Orlando this coming February.

His books include Better, Being Mortal: Medicine and What Matters in the End, Complications: A Surgeon’s Notes on an Imperfect Science, and The Checklist Manifesto. I gave one of his early books to all my IT leaders one holiday season. My tradition was to give them an insightful and inspiring book each year. Gawande’s books are clearly some of the best for health care leaders.

Gawande has been a staff writer for The New Yorker since 1998. His latest piece was titled “The Upgrade: Why Doctors Hate Their Computers”. It’s a long read but worth the time if you work in health IT and care about your physicians. Gawande describes the challenges of EHR’s from the front lines of medicine. He talks about the significant amount of time spent doing documentation after a patient visit and the loss of physician to patient connection with the computer competing for attention in the exam room.

In discussing physician burnout, he referenced Berkeley psychologist Christina Maslach’s work studying occupational burnout where she defined burnout as a combination of three distinct feelings – emotional exhaustion, depersonalization and a sense of personal ineffectiveness. He noted that in 2014, 54%% of physicians reported at least one of the three symptoms compared to 46% three years earlier. He shadowed a scribe and talked with surgeons and primary care physicians on the impact of the EHR on their work and their time. He learned from a patient who works as a construction supervisor that others are also challenged in their work to make the necessary human connections.

I won’t call it a spoiler alert. But this quote near the end of the article sums up a key message regarding the human connection between clinicians and patients:

“We can retune and streamline our systems, but we won’t find a magical sweet spot between competing imperatives. We can only insure that people always have the ability to turn away from their screens and see each other, colleague to colleague, clinician to patient, face to face.”

After reading Gawande’s article, Dr. Dirk Stanley, CMIO at UConn Health, wrote a very informative blog on the importance of clinical informatics – “The Offerings of Clinical Informatics”. It is also a long read. But if you want to truly understand the role of clinical informatics and its importance in EHR design, it is definitely worth reading.

The topic of physician satisfaction with EHRs and physician burnout is getting a lot of attention these days. As it should. It is a real issue that healthcare and IT leaders along with clinicians must address.

Dr. Amy Maneker is one of our clinical advisors at StarBridge Advisors. She is an experienced CMIO who has been educating others about the importance of fully engaging physicians in EHR design and implementations. She was a guest on Bill Russell’s podcast series, This Week in Health IT, in September where they discussed EHR usability, best practices, and informatics. She has been involved in the Arch Collaborative where physician survey results have shown the impact of training and organization culture on physician satisfaction. She recently wrote two blogs for KLAS – “Training is Key! Secrets to Successful Advanced Training” and “EHR Engagement and Ownership: Keys to Clinician Success”. A shorter version of the second blog was recently published on our StarBridge Advisors blog, View from the Bridge.

To learn more about the Arch Collaborative, you can listen to Bill Russell’s podcast interview with Taylor Davis, EVP Analysis and Strategy at KLAS. It was focused entirely on the work of the Arch Collaborative in measuring the results of EHRs and identifying best practices with an emphasis on physician satisfaction.

Physician satisfaction with EHRs and the multiple factors leading to physician burnout cannot be ignored. We owe it to our clinicians and the patients we serve.