Reducing the burden on physicians and teams: seven system-level changes

Burnout among physicians and teams is often related to system-induced distress and workplace burdens, yet too often interventions focus on individual efforts instead of system-wide reforms.

A recent report from the U.S. Surgeon General calls on health systems, insurers, government agencies, and others to implement broad changes, such as the following:

1. Reduce medical record documentation burden — e.g., clarify and unify rules across payers, reduce complexity, eliminate nonessential and duplicative elements, use team documentation where appropriate, and optimize the workflow.

2. Improve EHR usability — e.g., improve the user interface to reduce time spent in the EHR, improve EHR integration into workflows, improve the display of data to better support decision making, and improve interoperability across systems.

3. Simplify quality-reporting requirements — e.g., align measures across payers and adopt high-value, high-impact, evidence-based measures, such as those created by the Core Quality Measures Collaborative, to reduce data collection burden and promote better patient outcomes.

4. Increase work schedule flexibility and autonomy — e.g., recognize workers’ responsibilities outside of work (parenting, caregiving, etc.) and provide flexibility in work hours, allow workers to schedule their preferred days off, allow the use of virtual care when clinically appropriate, and provide job-sharing, cross-training, and other coverage options.

5. Reform payment models to recognize the value of a conversation, not just a procedure — e.g., move away from models in which clinicians feel penalized for spending the time they need with patients to provide adequate care, engage health workers in determining optimal visit length standards to ensure both efficiency and quality of care, and align incentives and payment systems.

6. Broaden care team delegation — e.g., add scribes or automate data collection for any needs that are secondary to clinical care such as billing, quality reporting, and regulatory requirements.

7. Reduce the overall volume of prior authorization requests, and streamline the process — e.g., eliminate unnecessary prior authorization requirements, use electronic and automated systems, and improve transparency, communication, and timely resolution of prior authorization requests.

What would you add to the list?

Posted on Jan. 23, 2023, by FPM Editors