How Healthcare Technology Can Improve, Worsen Provider Burnout

March 22, 2024 - Provider burnout is not new, but it has been an increasingly pressing topic as the pool of healthcare professionals shrinks.

Healthcare strikes point to underlying issues related to workforce strain. Additionally, the downstream effects of the coronavirus pandemic, which pushed burnout rates to 63 percent in 2021, continue to plague providers. Amid all of these pressures, higher rates of screentime, a lack of purpose, and workplace culture have fueled the exodus from healthcare.

In this episode, Michelle Flemmings, MD, industry executive and market development director for healthcare in North America's cloud infrastructure at Oracle Health, shares about how healthcare technologies have both helped and hurt the provider burnout prevention efforts and how to advocate for better workflows and solutions.

Where do we have an advantage? We have even more than just an advantage. It's incumbent upon us all as an industry to drive efficiency in the workflows, outside of the workflows, make it more intuitive as a byproduct of what I do in my day-to-day.

READ MORE: Providers Laud Prior Authorization Rule, EHRs Can Lower Provider Burnout

Kelsey Waddill:

Welcome to Season 2 of Industry Perspectives, our segment of Healthcare Strategies in which we interview top healthcare industry professionals live from conferences across the US. In this season, we are coming to you HIMSS 2024, which drew 30,000 attendees to Orlando, Florida for five days, to converse on topics ranging from generative AI and cybersecurity, to policy and interoperability.

In today's episode, our VP of editorial, Kyle Murphy, sat down with Dr. Michelle Flemmings, industry executive and market development director for healthcare in North America's cloud infrastructure at Oracle Health. Dr. Flemmings shares how provider organizations can better approach the issue of provider burnout, outlines the extent to which technology has played a role in burnout, and discusses what work-life balance really means to providers. Let's take a listen.

Kyle Murphy, PhD:

Dr. Flemmings, welcome to HIMSS '24 Orlando. No secret, we've spoken before but not about this. I wanted to first kick things off, if you could tell our audience a little bit about your work at Oracle Health and what you do.

READ MORE: How Providers Can Adopt Automation to Reduce Clinician Burnout

Michelle Flemmings, MD:

Well, I am the industry executive director for healthcare and market development in North America cloud infrastructure at Oracle.

Kyle Murphy, PhD:

Yes.

Michelle Flemmings, MD:

READ MORE: Top Healthcare Industry Predictions for 2024: Tech, Workforce, Costs

That was what, about 12 words?

Kyle Murphy, PhD:

Yes.

Michelle Flemmings, MD:

Big title meaning that I am the clinician and the physician strategist that helps make certain that our clients' needs and our patients' needs are met. I bridge especially between sales and the customer challenge, whatever that may be, and say, "This is the issue. These are the challenges, these are the problems. These are the steps we need to take. Let's consider this technology over here to solve this issue over there." A lot of fun, love it.

Kyle Murphy, PhD:

Now, providers are struggling and there's no shortage of technology being thrown at providers. It seems to have created just more problems than its created solutions. I'm curious from your vantage point, you come from a background in practicing medicine, how does technology help these providers who are dealing with burnout?

Michelle Flemmings, MD:

I will start with I come from the early ages of paper, where you wrote wherever on the paper and you hopefully were able to find what you wrote, and God forbid, five years later figure out what it said because it had faded. Coming into technology, what the advantage is, is that now being a digital record, the information's there.

Kyle Murphy, PhD:

Yeah.

Michelle Flemmings, MD:

It's able to be captured. It's able to be pulled into different areas and resources. It's able to be analyzed and insights driven. That's beautiful.

I'm also here to say that the burnout's not new. I started practicing medicine back in the '80s, and I have lost a lot of talented friends to burnout, even before the digital medical record. Where do we have an advantage? We have I think even more than just an advantage. It's incumbent upon us all as an industry to drive efficiency in the workflows, outside of the workflows, make it more intuitive. Make it something that happens as a byproduct of what I do in my day-to-day, not force me to go and push more buttons, or log in over here.

The possibility is finally getting the providers back to that sanctity of that patient-physician, patient-nurse, patient-RT relationship that the technology had gotten in the way of. It's a huge opportunity to re-envision all of the stuff that's going on with burnout and with overload, especially with providers now in EDs, critical care, et cetera, and make it better.

Kyle Murphy, PhD:

What are some logical first steps that these providers need, organizations need to think about when they're assessing or working with their technology?

Michelle Flemmings, MD:

I think starting and reverse engineering is key. What is the goal? Are you trying to add efficiency in say a carry out workflow? Are you trying to assess the throughput time of a patient in the emergency department? Start with what you're trying to accomplish, and then go backwards from there.

I'll be selfish, I'll go ED. That's what I do. For me, the nirvana would be let's put some AI in there, and let's start capturing the data that sits within the EHR, all of those timestamps, and really dial in on how long does it take after that patient gets there by EMS, to get their CAT scan done to make certain if they have a head bleed or not. Do they need to be flown somewhere to a neurosurgeon? Potentially, do they need a clot buster to get the clot out of their brain and get back to circulation? Let's really dial in the timelines utilizing the technology to drive the outcomes that the patients deserve. That's where I think we need to be.

Kyle Murphy, PhD:

How do we measure quality improvement, from a sense of the provider satisfaction level? What are we looking for? Obviously, we want work-life balance, we want those surveys to come back saying, "I got more satisfaction by spending more time with patients." Are there key indicators of here's a physician or clinician who's thriving because they're doing X, Y, and Z?

Michelle Flemmings, MD:

I will tell you true, that is a difficult one because it is so different for different people as to what work-life balance means. For me, when I was still in practice, I just retired about six months ago because of the demands of the job.

Kyle Murphy, PhD:

And then you went back to work.

Michelle Flemmings, MD:

And then I went back to work. [laughs] But what it means to me is time outside. I have Vitamin D time every day. I live in Southwest Colorado.

Kyle Murphy, PhD:

Gotcha.

Michelle Flemmings, MD:

Every day, I need 15 minutes of Vitamin D therapy, and I'm usually outside with my dogs. For the equivalent, when I was in the emergency department, what I wanted is I wanted to make certain that my charts were done and I wasn't reliving my shift, either that night because I'm still in the emergency department doing my documentation, or worse, three days from now and I can't remember what side of the bed I was on, and where the belly pain was.

Kyle Murphy, PhD:

Yeah.

Michelle Flemmings, MD:

You don't want to have a chart that doesn't really capture the essence of the event.

I think when we go forward, thinking about surveys we need to honestly, ask the providers themselves: what does work-life balance mean to you? And capture that, as opposed to what we think it should mean to them. Much like how we survey patients. With patients also in technology, there's an opportunity now, especially with the technology that we have around AI, to capture a lot of that patient feedback. What does your best life and living it mean to you? What does it mean to you when we talk about preventative health? Are you interested? How can we capture it in a manner that now, you say, "Wellness is a good choice, and I can do this, and I can help guide my team"? I think we need to turn it around and capture the insights.

Kyle Murphy, PhD:

Now you and I were talking before, we're both hopeful people, we're optimistic. Where do you see the bright lights across the healthcare system where we're starting to see maybe a turning of the tide for certain providers? And obviously, by extension, patients because if the provider's not present, you're not going to get the best care. Do we have some examples, or do you have maybe some anecdotes, just about what is fueling your optimism?

Michelle Flemmings, MD:

Oh, what fuels my optimism is every single conversation that I have with a COO, CMIO, CEO who says, "I think we're ready to move forward and do something big."

Kyle Murphy, PhD:

Yeah.

Michelle Flemmings, MD:

Usually, the conversation from there goes into something around operational efficiency. I love the topic of operational efficiency. What I especially love though, is the opportunity there to get some cost savings. When you're talking smaller hospitals, where the mission is the margin, and now you can find some technology that can help them not only to spend less, but capture more about "where am I overspending, where am I duplicating my efforts, where am I throwing money and nothing's happening." That is huge because now that money can go and fuel a different initiative. Maybe a primary care clinic down the road, maybe a pediatric neurologist in the neighborhood, something like that. That's magnificent.

After that, operational efficiency. Let's just make it better across the board, everybody involved in touching that patient during their encounter. From the front desk, stop having them answer the call about when the pharmacy is open. That can be handled by AI. Let's keep the nurses doing the work that they want to do, and not that they have to do. Let's help them with the documentation load. Let's make certain that we can maybe capture the vital signs, pull them into the record on their behalf, and have them then be the person in keeping that human in the healthcare spectrum of, "Yes, these are correct and this is what it means."

I also think on burden and on things like burnout. Clinical decision support is going to be important. That's the double-edged sword. How do you get in the right information, and make certain it's trustworthy, fit for purpose, the right person, the right time, the right circumstance, relevant without capturing something that's potentially a hallucination.

Kyle Murphy, PhD:

Yeah.

Michelle Flemmings, MD:

That's another area where we need to make certain that there's a human in there for the checks and balances, because as a physician, that's a concern that maybe something would be integrated into the record that I'm not recognizing because there's such an amount of data coming at me, and now unfortunately there's been a bad outcome. That's that edge of the "maybe not right yet."

On the other side of it though, there is a genuine, I think now, avenue open to really capture patients, and get them back and engaged in their care. A lot of them are passive consumers. Let's get the information out in a personalized fashion.

My sister is a breast cancer survivor. How about, when she was going in to go and get her surgery done, we do her discharge planning before she even gets to the hospital? I remember her saying, "I can't think of anything except thinking I'm potentially going to die on the OR table." You can't think about clinical trials, and your options open to you for traditional or alternative treatment when you're thinking, "I could die." Let's maybe turn it on its end, and maybe do the discharge planning when they're home with their family, and they can decide. Let's make it at her level, where she can understand. Let's capture docs in her area that are doing magnificent things. Or maybe some articles that she needs to help support her, to again, help her care team to understand what her best life after breast cancer means for her. Those are the beauty spots for me.

Kyle Murphy, PhD:

It's one of those things where the most important relationship in healthcare is the provider and the patient. We just need to get all this clutter out of the way.

Michelle Flemmings, MD:

Absolutely.

Kyle Murphy, PhD:

Technology can help. To me, what you're saying with efficiency, it's workflow, it's getting the cost savings as a time savings. Time is money and all that jazz. How do physicians go about advocating for themselves to get their leadership to say, "Hey, we need to do something here. Maybe this technology can work here" or, "You know what, maybe this technology doesn't work here and we could find an alternative"?

Michelle Flemmings, MD:

Wow. That tells my story because I was the CMIO at a hospital that was then implementing a new EHR. I made certain that I was involved in every step at the hospital. I also though challenged the vendor to make it even better for our providers. It had to serve the ED, it had to serve our clinic, it had to serve our surgeons. From there, I continued to consult with them, and to help them to make it better because without the input of the people who are the end users, who are taking the technology and affecting care, it's nothing. It's a bunch of gobbledygook.

Kyle Murphy, PhD:

Yeah.

Michelle Flemmings, MD:

Big scientific term. [laughs] But where I think it's important for providers to get involved is start with your CNO, if you're a nurse. Start with going to maybe the board meeting. The board meeting almost always has an open forum where you can start talking and saying, "Not for nothing, guys, this is great. But I've also seen this happen at a different hospital and I'm happy to connect you with their leadership to talk about what results they've had." I think those are magnificent moments to step into the spotlight.

Kyle Murphy, PhD:

Yeah.

Michelle Flemmings, MD:

I think also getting involved with your chapter. The American College of Emergency Physicians has a division that deals with the EHR and deals with data. I think coming to meetings like this and being part of the Physician Community Forum. If they are a client at Oracle Health, connect with me. I'm happy to navigate the path of wherever you want to go, need to go. I'm actually going to a couple of conferences that have nothing to do with work to support some amazing physician leaders out there who need their voice elevated. If I can help amplify that, connect on LinkedIn, let's do this. It's time.

Kyle Murphy, PhD:

They're people, too.

Michelle Flemmings, MD:

They are.

Kyle Murphy, PhD:

Doctors are people, too.

Michelle Flemmings, MD:

It's time. We need to help each other.

Kyle Murphy, PhD:

We've got to stop treating them like machines.

Michelle Flemmings, MD:

Yeah.

Kyle Murphy, PhD:

Well, thank you so much for the time. It was really nice talking to you.

Michelle Flemmings, MD:

Great to meet you in person.

Kyle Murphy, PhD:

Great to meet you in person as well.

Michelle Flemmings, MD:

Oh my word.

Kyle Murphy, PhD:

This has been wonderful. Enjoy your conference.

Michelle Flemmings, MD:

You as well. Thank you for the opportunity.

Kyle Murphy, PhD:

Take care.

Michelle Flemmings, MD:

You, too.

Kelsey Waddill:

Listeners, thank you for joining us for this episode of Healthcare Strategies Industry Perspectives. When you get a chance, subscribe to our channels on Spotify and Apple, and leave us a review to let us know what you think of this new series. More Industry Perspectives are on the way, so stay tuned.

This is a TechTarget production.