How Providers Can Adopt Automation to Reduce Clinician Burnout

December 21, 2023 - Automation could prove essential in the struggle to alleviate provider burnout, but adoption can be difficult.

In 2023, the American Hospital Association (AHA) released a document that assessed the American healthcare workforce. The report identified three core workforce challenges. 

First, it highlighted the need to reconnect providers with their sense of purpose. Second, it pointed out providers' lack of resources in certain areas such as training and technology. And lastly, it stressed the need for better strategies around recruitment and retention.

The US healthcare system's challenges have started to climax as the nation experiences an explosion of artificial intelligence and machine learning innovation. These technological advances have offered greater automation capabilities.

Could automation be the solution to some of the healthcare workforce's current issues? Russ Richmond, chief executive officer and co-founder of Laudio, offered his thoughts on the subject in this episode of Healthcre Strategies | Industry Perspectives.

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Russ Richmond: We've converted our caregivers into information finders, information connectors, documenters. We don't need them doing that stuff. And a lot of that is going to be the first step that gets automated with the new generation of AI and all of those things.

Kelsey Waddill: Hello, thanks for tuning into Healthcare Strategies | Industry Perspectives. This is our ninth and final conversation from the HLTH 2023 conference in Las Vegas, where we heard various perspectives on industry trends from leaders in healthcare technology. In this final episode, we dig into automation, a subject that has been met with mixed emotions in the healthcare workforce and beyond. On the one hand, some fear that the rise of automation will shrink the job market as machines replace humans. On the other hand, hospitals and health systems are in a desperate place regarding under-staffing, and many see automation as a savior for their increasingly overtaxed workforce.

So, is automation a boon or a bane? Our VP of Editorial, Kyle Murphy, caught up with Russ Richmond, CEO and co-founder of Laudio, to find out. Let's hear his answer.

Kyle Murphy: Well, Russ, thank you for joining us on Healthcare Strategies here at HLTH. Before we get into our talk, tell me a little bit about your professional self and what's your history, what's your background?

Russ Richmond: Sure. Thanks. Thanks for having me here. So my background is I'm a physician, and I spent 10 years as a McKinsey consultant doing health system operational work. And then I've got into digital health. I've been a digital health CEO for the last 15 years or so, both a startup founder and a professional CEO.

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Kyle Murphy: So what are... We, actually--I should say in full disclosure--we were chatting last night, so we were talking a lot about workforce. How did you get drawn into trying to develop a solution or trying to help these health systems really improve the way they deal with their workforce and manage them?

Russ Richmond: Two different ways. The first way is my prior company actually was an ed tech company that was educating both physicians and nurses. And through that business, I got a lot more familiar with the workforce operations, what they needed, what they were thinking about. And so that was sort of like a background educator. I'm also married to a physician. I've been a physician, I've been part of the workforce. And then finally, I was a patient for three months. So six years ago, I spent three months in the hospital. I got to know my caregivers very well. And through that experience, I got really interested in the workforce, because what they were telling me was they weren't happy in their jobs, but what I was feeling was that they were doing a great job taking care of me. And that disconnect is something that's really stayed with me and motivated me.

Kyle Murphy: So what is it about being a clinician? I mean, these folks get into this as a vocation. They're really dedicated to helping patients. But the demands of the jobs seem to not be aligned with their aspirations in terms of what they want out of their professional lives.

Russ Richmond: Right. Yeah. I mean, I start from the place that caregivers go into the profession because they actually do care. I mean, these are really good people.

And also interestingly, they're not afraid of hard work either. It's just that the job has gotten to the point where they feel fundamentally disrespected. They're giving away a lot of their personal time, their lifestyle, shifts around the clock, getting called in when they think they have a day off, working overtime to cover for whatever didn't happen, putting up with sicker and sicker patients, the acuity level is going up. Patients' families are becoming more difficult. Patient violence has been spiking, so these caregivers are getting assaulted. And then because of the complexity of care, it's a harder job. There's more data systems they have to keep track of. There's more protocols they have to remember, there's more scrutiny on their performance. And this is all falling onto the shoulders of a person that just wanted to take care of people. So we're kind of at a bursting point.

READ MORE: How a Rural Health System Reduces Turnover, Invests in Its Workforce

Kyle Murphy: Yeah. So obviously, one of the things that's come out of the pandemic is, and just now into more recent times, the workforce is kind of pushing back. We've got increased labor costs, which are eating into health system revenue and profits. So there's a lot of pushback there. You talk about being at an inflection point. How do these health systems that you work with, at least the ones who are kind of thinking about in the right way, how do they go about addressing this? How do they show to their workforce that we care about you, and that we're also being mindful about how we're using them and making sure that their day-to-day professional lives are productive, but also satisfying?

Russ Richmond: Right. And that's a challenge. They've got to be working on all fronts. On the revenue side, they simply need to be capturing more revenue, because that's helped them pay for some of the increase in costs on the labor side that we all know are the inexorable trend in all services industries, especially healthcare. So they've got to be lining up and getting better-paying patients in-house. They've got to find a way to take care of patients on a per member per month basis, versus an episodic basis. So on the revenue side, they're busy.

Then on the cost side, they really have limited places they can go to manage their costs. One of the places that we're seeing is all the management layers that sit between, say, a chief nursing officer and a direct caregiving nurse, a lot of health systems are looking at that and saying, "Do we need all of those layers? Does it have to be a manager, a director, a vice president, a senior vice president, or can we collapse some of that? Can we get more efficient?" Are they able to reconfigure the work so that folks are working at that top of their license? They're getting less expensive workers who do the less expensive items and bring in expertise where they need it, a good hard look at the work.

But fundamentally, they need to automate. I mean, automation is probably one of the only exit valves that they have because, if you think about it, they've got mandated staffing ratios in many states around how many patients per caregiver. And where you don't have those mandated ratios, you're morally bound to keep good ratios because it's about avoiding accidents, taking good care of people. So you can't thin that out much more than it's already been thinned out.

So then they have to look for other places to solve this problem. A big place is, as I said, going to be automation. We've converted our caregivers into information finders, information connectors, documenters, and now they're responsible for all these things that are outside the actual event of the laying on hands and the delivery of care. We don't need them doing that stuff. And a lot of that, in my mind, is going to be the first step that gets automated with the new generation of AI and all of those things.

Kyle Murphy: What are some of those tasks? Obviously, documentation is one of those things. There's this weird balance, and I wonder if you agree with this, where a lot of people worry about automation replacing workers. But in this case, it's actually--you need automation to keep those workers, right? So it's a weird paradigm shift.

Russ Richmond: I couldn't agree more with how you frame that. I mean, unless we can automate away the administrivia of care, we're not going to hang on to any of these people, because they're already full, you just can't put one more thing on top of them. So documentation is an obvious and easy mechanism, and I think a lot of folks are working on that.

But I mentioned something earlier, which is our caregivers now are, they're also data connectors. They've got to put information assets together from various systems, whether it's the clinical record, the vitals, the chart, or administrative systems like quality and safety reporting systems or other compliance-related activities. All of that burden is falling on them as well, and that can be an overwhelming amount on top of their existing job. And I think it's some of that sort of more back office data operation that actually AI and automation can really help us. And that's a frontier for us.

Even at the level of the leadership or the managers, as an example, they're responsible for connecting the data in their workforce systems--so, their Oracle, their Workday, their Kronos--to the EHR--their Cerner or their Epic--because they need to manage the teams they see in the workforce systems to the outcomes that they can see in the EHR. And all that concatenating, all that matching up of data, right now, that burden is on them, right?

Kyle Murphy: I have to imagine the cognitive load for these individuals is off the charts.

Russ Richmond: It's a huge load, and the cost of missing something is sort of the Damoclean sword that is sitting on top of every caregiver they don't want to miss. So that's a cognitive burden. That's an emotional burden that I think everyone on the front line of the care force is living with every day.

Kyle Murphy: Can we talk about, I mean, the solution and how imperative it is on these health systems to really address this issue straight on? We know that there's not enough new folks coming into the workforce. The workforce is aging. To me, that's a perfect storm that's likely to, I guess, really undermine these organizations financially. Is this something that they really need to address immediately?

Russ Richmond: Immediately. I mean, because as you're saying, there are huge supply constraints in the workforce. And that's a secular trend, it's not going away. You can map it a decade out. So we know we're stuck with that. So what are they doing in the face of that? I mean, during COVID, they got all kinds of travelers and contract labor in to fill the gaps. We know that didn't work well. It caused cost overruns. And there's also quality and safety issues with having a chimeric workforce on the ward at any given time. You've got some people that are full-time employees that understand all the systems, know the physicians, et cetera. You've got others that are just showing up for the day that can't even log in to get the chart.

So I mean, the ultimate goal has got to be to maintain a full-time employee workforce, but to give them the types of flexibility and support they need to manage their job like an online staffing opportunity.

Kyle Murphy: How do these--if a health system that's kind of feeling this crunch, how do they get started to really think about making changes? You guys obviously have a solution, but I guess from an assessment, kind of self-evaluation standpoint, what are the first steps that they need to take in order to really affect some kind of change so that the future starts to look a little bit brighter rather than...

Russ Richmond: Yeah, I think that they can't manage what they can't measure. Everyone can measure an engagement or turnover rate, but then what do you do with that information? What we're seeing is that obviously through the pandemic, that became very important for everyone to know and understand, but we don't quite have people getting promoted or paid yet on their ability to manage those metrics and to keep them under control. So what I would love to see is something like the equivalent of an employee net promoter score, something you can manage on a daily or weekly basis, be part of the ongoing measurement and evaluation and promotion and bonus payouts of everyone in the health system. I think that would do something to change a lot.

Then, they need to get behind the drivers of why people are turning over and why are they leaving. I mean, like I said, people aren't afraid of working hard, and they want to deliver care.

So those two things are in place. What are we doing that's getting in the way of those two laudable goals and causing people to leave? And a lot of it is things like inflexibility on schedule, lack of appreciation. Sometimes it's payment, not always it's payment, but it could be taking a good look at wage rates. Promotional pathways. Are we taking care of our new hires? The new hire window--the one- to three-year window--is the highest click rate window, right? There's also an old adage that, "nurses eat their young"--which I hate, but it's like you've got some long-time tendered employees that aren't looking out for the new incomers and folding them into the team, building those social bonds and relationships that are the glue at work, and that interpersonal connection. So it's not one thing, it's like 10 things, and they all have to happen all at once. It's a big challenge.

Kyle Murphy: Well, thank you so much for joining us today. I really appreciate it. This is obviously an issue that's not going away. And if strikes are any indication of where the workforce is, there's obviously a need for some kind of positive disruption or just a way of managing these things much more efficiently.

Russ Richmond: I mean, that's the world we're in. I really appreciate you guys highlighting the topic. It's an important topic.

Kyle Murphy: Thank you so much.

Russ Richmond: Thank you.

Kelsey Waddill: Listeners, thank you as always for tuning into this final episode of Industry Perspectives. We hope you enjoyed these conversations as much as we did. We might be wrapping up this mini-series, but we will be back in the new year with more episodes of Healthcare Strategies and Healthcare Strategies | Headlines. After a little holiday break, our next episode of Healthcare Strategies will air on January 8th, and it'll be all about what our editorial staff is hearing about predictions for healthcare in 2024. So be sure to follow us on Spotify, Apple, or wherever you listen to get those new conversations in your feed. Have a great end to 2023 friends, and we'll chat in the new year!