Addressing clinician burnout with operational and technology focused initiatives

Contributing Authors

Eve Cunningham, MD, Chief of Virtual Care and Digital Health

Maulin Shah, MD, System Chief Medical Information Officer

Scott Smitherman, MD, Ambulatory Chief Medical Information Officer

Meredith Sefa, Vice President, Strategic Integrations

Jessica Schlicher, MD, Chief Medical Officer, Virtual Care and Digital Health

The global pandemic may be behind us but burnout in the medical field is still a significant area of concern. Thus, it’s important to not only learn from your own experiences but to examine how others work through staff burnout and what they find as effective solutions. Read on to learn how the team at Providence addresses burnout through multiple initiatives designed to promote provider engagement, retention and joy, and some of their positive, measurable outcomes.

At Providence, we recognize that addressing burnout in healthcare goes beyond mindfulness training and the Electronic Medical Record (EMR) elbow support. Restoring joy in the practice of medicine and “easing the way” is part of our promise to our clinicians and caregivers.  We recognize that no single solution solves the burnout challenge, but rather a toolkit of innovative solutions strategically crafted together so they can fit seamlessly into clinical workflows, provide complementary support for the clinicians, and meet clinicians where they are. We believe that by improving the experience of delivering care, we will improve the experience of receiving care for our patients. We are also very committed to measuring the impact of our solutions in a scientific way to ensure that the “bright and shiny tool” we have both invested in, and brought into our clinical front line, is actually delivering meaningful impact.

Our greatest areas of focus this year for addressing burnout includes documentation support, with ambient technology through Nuance’s Dragon Ambient eXperience (DAX); a co-pilot product for clinicians, called MedPearl, to support medical knowledge management and specialty referral clinical decision support; and lastly, multiple strategies and tactics to address inbox management burden via leveraging new technologies like, ProvARIA, which leverages AI and large language models to categorize patient messages and pre-draft responses, and the formation of centralized in-basket management teams with virtual nurses and medical assistants that can offload inbasket burden for clinicians over a large geography. We currently measure the impact that could be drivers for burnout/burden for these strategies in the following ways:

• DAX
  We use signal data within the EMR to tell us whether providers have reduced their “pajama time,” or time spent documenting outside of regular work hours. We also measure note length in the hopes of reducing “note bloat.”
• MedPearl
  We digitally capture feedback from the clinician end-users to measure before and after implementation of MedPearl regarding the level of confidence in decision making around specialty referrals, ability to avoid unnecessary referrals, and identification of the level of urgency for a referral. We also measure NPS, volumes and adoption.
• ProvARIA
  Still in early phase of development, ProvARIA leverages AI and LLM to auto categorize patient messages and provide a recommended draft response. Initial testing with this new technology has been very promising for a game-changing future.
• Centralized In-basket Management
  We measure time to answer a patient message, inbox message volume, and provider satisfaction before and after implementation of tactics.

All the above solutions have resulted in positive measurable impact at the point of care. At Providence, all of our initiatives designed to address aspects of burnout have been prioritized and developed from the grassroots. We believe in the importance of elevating the clinician voice and approaching solutions that are designed around them and their needs, so they can focus more on their patients.