Reduce Clinician Workload With One Key Change to Your Process
Clinician burnout and shortages have been making healthcare headlines for quite some time with the WHO estimating that the world will need 6 million more nurses by 2030[1]. It is estimated the US will need 1.2 million more nurses by 2030, enough to replace all the baby boom RNs who will retire over the decade. Numerous factors such as lagging effects of the pandemic, reporting requirements due to value-based care models, and 24/7 technologies further exacerbate provider burdens. Although electronic medical records (EMR) represent a major advance in modern healthcare, they have brought some unexpected challenges for providers. Clinicians are often inundated with patient messages and system notifications that require attention.
Together, these factors create a perfect storm where increasing numbers of providers are looking to leave their jobs or retire early. Surveys have found that 41% of nurses say they plan to leave their job, while 26% of physicians say they plan to retire early. Job burnout and overwork are the top reasons given.[2],[3]
Hospitals and health systems can mitigate some of these challenges with one key change: leveraging care coordination services, including virtual nurses. Virtual nursing services can bring significant benefits to providers—and relief for staff—from the very first day. Virtual nurses can help address workforce shortages and can field a wide variety of tasks such as symptom assessment, prescription refills, message management, documentation, and more. Virtual nursing programs are expanding at a rapid rate with a 34 percent increase around the U.S. over the past year with no signs of slowing down, according to one research and consulting firm.
Provider Inboxes Overflow with Patient Messages
With the proliferation of EHRs, patients have embraced a new way to connect with their providers. The advent of patient messaging via EHRs directly to the physician, skipping support staff, has created a radical increase in patient messaging volume, leaving less time for direct patient care.
According to a recent commentary on EHR inboxes, “Immediate access to one’s physician for non-urgent questions in real time is highly valued and can be valuable; direct access to one’s physician may even be advertised by institutions as a service differentiator in local competitive markets, and yet we have not yet developed the care teams and compensation models designed to deliver care in this way.”[4]
Below are statistics about the current state of the physician’s inbox:[5]
- Pre-pandemic, the average family physician spent 1.5 hours per day on the inbox.
- At one health system, physicians addressed an average of 100 inbox messages daily during working hours and another 50 each weekday evening.
- The number of patient messages increased by 157% at the onset of the pandemic and have remained at this “new normal” level ever since.
- Over 1/3 of inbox messages are system-generated and include many low-value communications.
- US clinicians received nearly 3 times as many inbox messages as clinicians in non-US countries.
Inbox activity accelerated during the pandemic without the workflows, teamwork, and payment models to make it manageable. Physicians now spend hours on patient messaging which may have been billable had these conversations occurred in the context of a visit. Meanwhile, the expectations for patient contact hours and relative value unit (RVU) productivity have not decreased in response to the growth of their inboxes.
Patient messaging and other EHR tasks are time intensive and can spill into a physician’s personal time, contributing to burnout. A 2020 study cited EHR-related factors as one of the top two factors most closely associated with intent to quit. Fifty-six percent of respondents who were “very dissatisfied” or “dissatisfied” with their EHR said they planned to leave, versus 29% of those were “satisfied” or “very satisfied,” according to the study.[6]
Health systems are using a variety of strategies to manage overflowing provider inboxes such as turning off low-value notifications like test orders sent in real time to multiple physicians and instead, only notifying the ordering physician of the test result. Others are delegating to a more robust team—even a qualified clinical support team of virtual nurses who can monitor and manage messages consistently throughout the day.
Virtual Nurses Help with Inbox Message Management
Optimizing inbox management via virtual nurses can balance clinician workload and alleviate stress on clinicians. Plus, effectively triaging and responding to incoming patient messages can mean the difference between positive and negative patient experiences and health outcomes.
Virtual nurses are well-versed in clinical matters and can readily handle message triage including:
- Responding to patient’s visit follow up questions
- Assessing patient symptoms
- Recommending the proper levels of care
- Routing messages to the appropriate provider
- Scheduling patient appointments and referrals
- Refilling prescriptions and answering medication questions
- Addressing non-urgent medical questions
- Responding to test result questions
Inbox message management, triage services, and other care coordination services provided by Omega Healthcare can help reduce physician workload and extend your team’s capabilities while reducing costs, increasing patient interaction time, and maximizing reimbursements. Here’s one success story that shows how a large New York health system reduced physician burnout with virtual nurses and care coordination services from Omega.
Thousands of Patient Messages Overwhelm Doctors and Staff
When NYU Langone Health completed a successful Electronic Medical Records system implementation, the patient population responded enthusiastically. Patients quickly learned to use and benefit from the features that allowed them to email providers and staff via the EMR system. They were able to ask questions, request records, schedule appointments, inquire about new and existing conditions, and more.
The popularity of this powerful new communication tool had a flip side no one fully understood or anticipated in advance. Rapid patient adoption and use meant there were suddenly thousands of additional messages for doctors and staff — messages that had never existed in the past.
And as is often the case with electronic communication, exchanges were rarely limited to a single message. It was usually several exchanges in a single thread and, as patients became more and more sophisticated in their use of the portal, the number of messages increased rapidly.
Nor was the added workload confined to the doctors. While many of the messages were directed at doctors, most of them were going to staff. It didn’t take long to see that the number of messages was growing rapidly – up to tens of thousands of messages across multiple practices.
A New Way to Manage Patient Messages across Practices
One of the key requirements the health system identified was a partner that could provide resources that were skilled, trained, and able to work as part of their team. To help meet the increasing communication demand, NYU Langone chose Omega Healthcare’s Care Coordination Services, which provides certified virtual nurses to support care management, patient outreach, payor interaction, and clinical documentation initiatives for the health system.
Omega Healthcare’s virtual nurses are now the first to see, evaluate, and answer incoming patient calls and messages. Fully licensed in the State of New York, they work directly within NYU Langone’s EHR, asking patients about their symptoms, existing health problems, and any relevant history of medical issues. The nurses use the health system’s protocols, decision tree, database, and workflow to understand patient needs, conditions, and potential treatments, and then recommend the proper level of care.
The Results Speak For Themselves
Omega Healthcare has relieved the burden of the unexpected new stream of work and given physicians and staff more time. Clinical teams in the health system’s practices now have more time to focus on face-to-face interactions, allowing them to grow their volume without adding staff.
Omega Healthcare’s Care Coordination Services
Omega Healthcare’s Care Coordination Services help healthcare organizations seamlessly capitalize on the expertise of hundreds of qualified, certified virtual nurses to support care management initiatives.
Omega Healthcare’s licensed and registered nurses have years of industry experience and are trained in the use of more than eighty of the top healthcare management systems. Omega Healthcare’s Care Coordination Services relieve the “unexpected” messaging and administrative burden and gives physicians more time to spend with patients – reducing clinician stress and burnout.
To learn more about our Care Coordination Services including telephone and message triage, remote patient monitoring, and customer contact centers, download our whitepaper, “Key Opportunities to Mitigate Clinician Shortages.”
[1] “The Rise of the Virtual Nurse,” Melissa Delaney, HealthTech Magazine, September 1, 2022
[2] “Doctors not the only ones feeling burned out,” The Harvard Gazette, March 31, 2023
[3] “More physicians want to leave their jobs as pay rates fall, survey finds,” Hailey Mensik, Healthcare Dive March 23, 2023
[4] “The Electronic Health Record Inbox: Recommendations for Relief,” Christine A. Sinsky, M.D., Tait D. Shanafelt, M.D., and Jonathan A. Ripp, M.D., M.P.H., National Library of Medicine, August 29, 2022
[5] Ibid
[6] “Reducing burnout could also improve staff retention, survey finds,” Jeffrey, Bendix, Medical Economics, April 21, 2022