How to Use Technology to Ease Physician Burnout

Baptist Health is using technology tools such as voice recognition software that generates clinical notes to reduce administrative burden on physicians.

Technology can ease administrative burdens on physicians and improve physician satisfaction, says Brett Oliver, MD, chief medical information officer at Baptist Health.

The physician burnout level and other measures of physician distress increased dramatically during the coronavirus pandemic, survey research shows. The findings of the 2021 survey are troubling, with 62.8% of physicians reporting at least one symptom of burnout compared with 38.2% in 2020.

Medical technology is maturing and holds great promise for helping physicians, Oliver says. "For many years, technology has been seen to be a burden for physicians. I practiced family medicine for 25 years, so I remember the transition to electronic health records as well as other technologies, and we are at a tipping point in terms of technology where we can now make a positive difference for my colleagues."

A good example of technology that reduces administrative burden for physicians is Nuance's Dragon, which began as voice-recognition software that allowed physicians to dictate their clinical notes. he says.

"The difference in the technology now with what they call their Dragon Ambient eXperience is the physician does not dictate anything. The physician comes in the room. After getting permission from the patient, the physician hits the start button, and Dragon Ambient eXperience records the conversation. It records the whole interaction. It's not a transcript. The AI develops a summary note of that interaction with the patient. They have integrated ChatGPT4—generative AI—into the model, which generates the note in real time," Oliver says.

When the physician is done seeing the patient, the note is there for the physician to look at, he says. "The physician can make additions or corrections. Then the note can be filed away, and the physician is done. There is a huge lift of administrative burden."

Benefits of remote patient monitoring

Remote patient monitoring (RPM) can boost physician satisfaction, Oliver says.

Baptist Health has been using RPM technology developed by Current Health for about three years. Current Health has a device that the patient wears on their arm. It can either sit on the arm with a band or it has an adhesive that sticks on the arm. The device records multiple parameters such as heart rate and pulse oximetry. There is a scale that goes with the kit, so when patients weigh themselves on the scale, it is transmitted to the device. The technology is integrated into the Baptist Health EHR, so the data flows back to the health system, just like physicians would see other data on a patient. Clinicians do not have to go to another screen or another dashboard.

Initially, Baptist Health used the Current Health RPM technology for patients with chronic obstructive pulmonary disease and heart failure, but that pilot was disrupted in about six weeks when the coronavirus pandemic hit, Oliver says. "We were watching some hospitals getting overrun and we pivoted to use Current Health for our COVID patients to send them home with monitoring. We sent more than 350 COVID patients home with the Current Health device, and we did not have any of them readmitted."

Once the pandemic passed the crisis phase and Baptist Health realized it was not going to be overwhelmed, the health system went back to using Current Health RPM technology for heart failure patients, he says. "We had a heart failure clinic set up already, we just added remote monitoring to that clinic. In our Louisville market, we had about 55 patients over the course of nine months take the Current Health device home. This was a high-risk group of patients—you would predict a readmission rate in 30 days of 18% to 22%. For those 55 patients, we had nobody readmitted at 30 days. When you have those kind of successes as a clinician, it invigorates you. It is burnout-reducing."

Optimizing the EHR

Baptist Health has been focusing its EHR optimization efforts on the EHR in-basket messages to physicians, Oliver says.

"Since COVID hit, in-basket messages for physicians have gone through the roof. They are not a bad thing—we do not want to get rid of them. They are an efficient way of dealing with patient questions, but the volume has gotten crazy. We have some AI in place now so that if a physician has a back-and-forth with a patient, and the patient says, 'Thank you,' and there is no other clinical information, we are experimenting with AI that will close that conversation without the physician getting another in-basket message. These are not a lot of messages—about 5% of the total—but if you take one out of 20 messages out of the mix, it makes a difference."

Baptist Health is also using generative AI to come up with possible answers to patients' in-basket messages, he says. "The physician is alerted to a potential reply, and they are asked whether they want to modify it or just send it."

In addition, the health system is trying to limit the number of in-basket messages coming to physicians, Oliver says. "Number One, does a message even need to come to the physician? In the electronic world, it has made it so easy to send a message about anything to anybody. We are trying to filter messages that do not bring clinical value. It may still need to be in the chart, but does the physician have to address every message?"