Streamlining, filtering communication to combat burnout

This year’s Medscape Physician Burnout & Depression Report highlighted two statistics that are shocking but not surprising. Emergency department (ED) physicians report the highest rates of burnout, at 63%, and 62% of physicians said bureaucratic tasks such as responding to portal messages are the primary reason they experience burnout. Simple steps to improve the way physicians communicate with each other, and with patients, could alleviate some of these burdens.

Poor communication seeps into many parts of care delivery. There are often negative consequences for clinical operations as well as patient experience.

• Nurses who can’t reach the attending physician to answer critical questions about a patient’s condition may leave patients waiting for news about what will happen next.
• Physicians who haven’t seen the results of a recent lab or scan may order another test. This causes patients to receive duplicative services and results in diminished care quality.
• An ED that can’t reach the intensive care unit (ICU), or an ICU that can’t reach the post-acute care facility, may be forced to delay a patient’s transfer.
• On the other hand, in the haste of a rushed transfer, key information from the patient’s record may not be shared. This may cause the patient to receive inadequate or inappropriate treatment at their new care site.
• Similarly, care teams may not provide patients and their caregivers with adequate education about their diagnosis and treatment at the dime of discharge. This may lead patients to send multiple messages to their care teams.

Several years ago, the American Medical Association (AMA) noted how improving communication within the hospital may address some of burnout’s root causes. Clear communication enables care teams to make more informed decisions, which may reduce medical errors and their negative consequences. In addition, AMA indicated physicians and nurses who participate in communication training may be more confident when talking to patients, which helps reduce stress.

Various technology tools can streamline care team communications. Text messaging can reduce the reliance on phone calls and pages. Receipts can show that someone opened a message, and automation features can let message recipients send pre-populated replies. To reduce alert fatigue commonly associated with burnout in the inpatient settings, messages can be prioritized, with priorities differing among business units. Finally, multimedia messages can allow recipients to look at images or charts without the need to find a free workstation.

Embedding communication within familiar workflows and technology tools is critical to successful adoption. To that end, the U.S. Surgeon General encouraged vendors to design technology “with the goal of interoperability at the outset” and with “seamless storage of and access to health data.” This is critical for meeting the needs of care teams across the continuum of care — and for ensuring technology itself doesn’t continue to be a root cause of frustration and burnout.

Hospitals’ efforts to improve communication and reduce burnout should extend beyond the ED. The negative impact of reading messages from patients after hours is well known; it’s exacerbated if patients are confused about their treatment plan, frustrated about navigating the healthcare system, or just plain mad.

Here, a Journal of the American Medical Association (JAMA) paper suggested natural language processing filters on inbound messages from patients may offer burnout benefits. In the moment, NLP can filter out negative messages, such as those containing expletives or violent messages, and spare physicians from the worst of them. Over the long term, NLP can identify opportunities to improve care quality and patient experience — for example, by seeing which medical conditions are most associated with requests for additional information.

Brian Eastwood is a Boston-based writer with more than 10 years of experience covering healthcare IT and healthcare delivery. He also writes about enterprise IT, consumer technology, and corporate leadership.