Clinician Engagement

Insights

Health Catalyst Editors

Removing Barriers to Clinician Engagement: Partnerships in Improvement Work

With clinicians driving many of the decisions that affect health system quality and cost, they’re an essential part of successful improvement efforts. Clinicians are, however, notoriously overburdened in today’s healthcare setting, and getting their buy-in for additional projects is often a big challenge. To successfully partner with these professionals in improvement work, health systems must develop engagement strategies that prioritize clinician needs and concerns and leverage data that’s meaningful to clinicians.
Improvement leaders can approach clinician engagement on three levels:

Clinician-led local programs.
Department- or division-level programs.
Leadership-level growth and improvement programs.

Tarah Neujahr Bryan

Survey Points to Major Burnout Concerns Among Clinicians

According to a November 2019 survey, 62 percent of clinicians and other healthcare professionals view burnout as a major problem industrywide. When asked for the best way to address clinician burnout problems, the most popular solution was less-complex workflows, which is the aim of emerging point-of-care analytics solutions.
Responses to additional questions reveal more about clinician burnout experience and views on the technology designed to help:

At your organization, how big of a problem is clinician burnout?
What is the best way to solve clinician burnout problems?
What are the biggest barriers to adopting closed-loop, point-of-care analytics capabilities at your organization
What are the biggest problems arising from a lack of adopting closed-loop, point-of-care analytics capabilities?

Ed Corbett, MD

Physician Burnout and the EHR: Addressing Five Common Burdens

So far, the EHR hasn’t delivered on its original intent to improve patient care with more efficiency and personalization and lower cost. Instead, physician users blame the systems for worsening their experience and the quality of their care in significant ways:

Less time for patient interaction and worsened quality of interaction.
An extended workday.
Poor design (difficult to use).
Demands of quality measures.
Cost and maintenance.

Despite these challenges, the EHR is likely here to stay. Health systems have invested heavily in their electronic reporting systems and are now focused on making these technologies and processes work for the benefit of patients and providers. CIOs are working towards better aligning digital health goals with physician experience for an environment where EHRs enable smarter, not harder, work.

Daniel Orenstein, JD

EHR Integration: Achieving this Digital Health Imperative

As the digital trajectory of healthcare rises, health systems have an array of new resources available to make more effective and timely care decisions. However, to use these data analytics, machine learning, predictive analytics, and wellness applications to gain real-time, data-driven insight at the point of care, health systems must fully integrate the tools with their EHRs. Integration brings technical and administrative challenges, requiring organizations to coordinate around standards, administrative processes, regulatory principles, and functional integration, as well as develop compelling integration use cases that drive demand. When realized, full EHR integration will allow clinicians to leverage data from across the continuum of care (from health plan to patient-generated data) to improve patient diagnosis and treatment.

Daniel Orenstein, JD

Interoperability in Healthcare Delivers Critical Health Information at the Point of Care

Interoperability in healthcare, despite frequent objections by EHR vendors and health systems (e.g. “EHR integration is too difficult to manage”), is integral to delivering high quality patient care.
Interoperability means different things to different health system stakeholders, from leaders seeing it as a purchase they must defend, to clinicians relying on it to get the information they need, when they need it. But it boils down to delivering the highest-quality, most effective, and most efficient care to patients—a goal that’s easier to define than achieve.
One of interoperability’s most important use cases, EHR integration, is challenged by EHR vendors and health systems worried about integration challenges, from HIT vendors wanting to integrate too many tools, to EHR access fears. Fortunately, objections are dissipating with the introduction of national interoperability policy and better cooperation among industry participants.
Amidst these distractions, health systems need to regain focus on interoperability’s top goal: improving patient care by making the best information available at the point of care.

Bryan Oshiro, MD

6 Proven Strategies for Engaging Physicians—and 4 Ways to Fail

For healthcare organizations to be successful with their quality and cost improvement initiatives, physicians must be engaged with the proposed changes. But many physicians are not engaged because their morale is suffering. While some strategies to encourage buy-in for improvement initiatives don’t work, there are six strategies that have proven to be effective: (1) discover a common purpose, (2) adopt an engaging style, (3) turn physicians into partners, not customers, (4) segment the engagement plan, (5) use “engaging” improvement methods, and (6) provide them with backup—all the way to the board. Once the organization has their trust, physicians will gain enthusiasm to move forward with improvement efforts that will benefit everyone.

Bryan Oshiro, MD

The Best Way Hospitals Can Engage Physicians, Nurses, and Staff

A big key to improving quality and patient care is engaging physicians and nurses. As many healthcare systems begin to implement improvement initiatives, they must ensure their clinicians are supportive and engaged in order to achieve success. Senior-level executives need to understand the challenges their clinical staff are facing in feeling overwhelmed, having too little time, as well as not really understanding new risk-based payment models. Knowing what motivates physicians and nurses to engage (and what doesn’t) ensures process improvements become tangible, sustainable, while at the same time building trust between clinicians and the healthcare organization.

Jared Crapo

Evaluating an EHR-Centric vs Data Warehouse-Centric Analytics Strategy: Seven Points to Ponder

Too much is at stake in value-based healthcare and the technology needed to provide it. When it comes to investing in the best healthcare analytics tools for delivering data-driven care management and outcomes improvement, executives should compare these seven points to determine whether an electronic health record or an enterprise data warehouse should be the foundation of their analytics platform:

Incorporating data from a wide range of sources
Ease of reporting
The data mart concept
Relevance of each to value-based care
Relevance of each to managing population health
Surfacing results of sophisticated analysis for physicians at the right time
Ability to combine best practices, data, and technology tools into a system of improvement

This executive report starts by examining the origin of EHRs and EDWs, then dives into the value derived from both in terms of their contributions to the major issues impacting healthcare delivery today.

Bryan Oshiro, MD
Charles Macias, MD

Engaging Physicians to Be Good Financial Stewards

This article, first published by in July 2016 by hfma, outlines how hospitals can get physicians to understand the financial impact of their clinical decisions and become actively engaged in improving the value of care. Texas Children’s Hospital was successful through recognizing the need for cultural transformation and ensuring quality came first. The organization engaged clinicians with financial data, including educating them on key financial principles, linking quality improvement training with financial accountability, and accompanying financial choices with clinical choices.

Sean Stohl

Healthcare Interoperability: New Tactics and Technology

Every provider agrees on the need for healthcare interoperability to achieve clinical data insights at the point of care. The question is how to get there from the myriad technologies and the volumes of data that comprise electronic medical records. It’s been difficult to organize among participants that have had little incentive to cooperate. And standards for sending and receiving data have been slow to develop. This is changing, but the key components that are still vital to realizing insights are closed-loop analytics and its accompanying tools, an enterprise data warehouse and analytics applications. This article defines the problems and explores the solutions to optimizing clinical decision making where it’s needed most.

Ed Corbett, MD

The Best Way to Optimize Physician Workflow

Optimize physician workflow and you’ll contribute to optimizing patient care. But what is it physicians look for to improve diagnoses, decision-making, patient care, and ultimately, outcomes? To answer this, consider what constitutes ideal working conditions in any industry: the right tools, training, and information to maximize productivity and deliver results. Physicians need analytics integrated into the EHR to maximize their efficiency, a common quest among the chronically overworked. And by flowing the universe of global, local, and individual data back into an enterprise data warehouse, a healthcare system can close the analytics loop, and begin to realize true precision medicine.

Bryan Oshiro, MD

Analytics in Medical Practice: How to Get Physicians On Board and Engaged

The Affordable Care Act has changed the landscape for physicians. They are under pressure to care for patients more effectively and efficiently. However, the significant increase in diagnostic testing and treatments have made it challenging for physicians to decide on an optimal diagnosis and treatment plan. Meaningful, actionable data to measure the effectiveness of these treatments has only recently become available, delaying the adoption and use of analytics among physicians. Integration and use analytics in medical practices is critical to improve outcomes, shorten the timeline for translating best practices into clinical practice, and ultimately improve the overall health of individual and populations of patients.

John Haughom, MD

Three Ways Doctors Can Use Patient Data to Get Better Results

Vast new pools of patient data will become available to physicians over the next few years. This data will change our understanding of health and disease, providing a rich new resource to improve clinical care and maximize patient health and well-being. Three ways physician will use this data to drive transformation include: 1. Efficient and effective operations (reducing wasteful spending); 2. Manage population health; and 3. New technology-enabled care and personalized medicine. The impact of new data on healthcare costs will be immense.

David Burton, MD

Data Management and Healthcare: Why Databases and EMRs Don’t Make the Cut on Their Own

Healthcare organizations preparing for the value-based payment model shift have found their internal resources pushed to the limit. Often, in an attempt to address regulatory timetables, systems will use point solutions rather than move toward a long-term strategy of developing robust clinical analytics. If an organization is using their EHR for analytics, they will soon discover that these built-in analytics packages cannot help them identify opportunities for cost effectiveness and clinical best practices. Sophisticated data management and healthcare analytics solutions, however, can provide leaders with the integrated clinical, financial, and patient satisfaction data they need to transform their systems into data-driven enterprises.

John Haughom, MD

A Time for Revolutionary Thinking: Three Things Clinicians Can Do to Shape the Debate on Healthcare Reform

Politicians and policy makers should not be leading the charge for change in the healthcare industry. Healthcare costs have spiraled out of control, and the healthcare mantra “first do no harm” doesn’t seem to apply anymore when we consider that there is, actually, an acceptable level of harm in the care we provide today. Clinicians need to lead the charge to build a new system that is well-resourced but affordable and efficient. This challenge is too important to be left to politicians and policymakers. The new system must be data-driven, outcomes-focused, and deliver the appropriate level and type of care, no more, no less. If we view this challenge as an opportunity, there’s no telling what we can accomplish.

John Haughom, MD

Preventable Medical Errors: The Future is Calling Us

Healthcare’s journey to improving care and reducing preventable medical errors is a difficult one. But those who embrace the changes are finding new, exciting opportunities. Some of the new realities are reflected in the American Board of Medical Specialties Maintenance of Certification program: Professionalism, Patient care, Medical knowledge, Practice-based learning and improvement, Interpersonal and communication skills, and Systems-based practice. While this has created considerable friction, it is possible to make this shift as part of an integrated practice, like Mayo Clinic and M.D. Anderson Cancer Center have done. Healthcare needs an environment to better manage complexity, not add to it. This is possible and it is happening today.

Bryan Oshiro, MD

My Wake-Up Call: How Data Saves Lives

Have you ever had one of those “wake up moments” where you literally learn a lesson that impacts and changes the trajectory of your life?   Read this personal story by Dr. Bryan Oshiro of his “wake up” call where he learned the importance of data to save lives.  He learned this first-hand when he saw rows of babies on ventilators in the neonatal unit and realized that they had all been electively delivered before 39 weeks. But he didn’t have the data compiled to make a compelling case to his physicians to stop elective pre-39 week deliveries. Working with his technology team, he gathered the data, analyzed it, and successfully engaged his physician team in a quality improvement project to reduce these elective deliveries.

John Haughom, MD

Becoming the Change Agent Your Healthcare System Needs

I’ve met many clinical and operational leaders across the U.S. and seen how many have become progressively cynical and disengaged when faced with important healthcare reform issues like cost cutting and tight budgets. These clinicians would agree that equally important are quality and safety issues. However, most don’t have the tools available to actually measure that quality or patient outcomes. When clinicians do have access to the ability to measure, and the work together, I’ve seen enormous energy arise as they ask questions they really care about: What is quality? What do we measure? How do we achieve the best outcome? 

John Haughom, MD

Will Healthcare Transformation Affect the Rule of Rescue?

The Rule of Rescue has held particular significance in the United States where the importance of the individual has long been a part of our cultural fabric. In the U.S., we tend to count ourselves as not fully human unless we pull out all the stops. Increasingly, however, healthcare ethicists and policymakers are asking whether this same moral instinct to rescue, regardless of cost, should be applied in the emergency room, the hospital or the community clinic.

Kevin Croston, MD

7 Tips for Increasing Physician Engagement

Starting a clinical quality improvement initiative requires shifting from a personality-centric culture to one that is data-driven, with near real-time data to help providers make better decisions and improve the quality of outcomes. But turning plentiful data into meaningful information represents a significant change. From Dr. J. Kevin Croston, MD, CMO at North Memorial Health Care, here are seven tips to gaining physician buy-in: 1. Get the Physicians Engaged Early; 2. Find Champions Among the Medical Leadership; 3. If Your Project Is Large, Choose One Area of Focus; 4. Build a Broad but Specific Guidance Team; 5. One You Have  Plan, Follow It; 6. Make the Results Data-driven; 7. Be an Agent for Change

Charles Macias, MD

Are EHRs Truly Improving the Quality of Healthcare? A Closer Look.

We know that healthcare costs are increasing and that value will become more important than ever. But the concept of value can be subjective. When it comes to healthcare, we can’t afford to be subjective in our assessment of value. I like referring to the Porter equation where value is equal to quality over cost. What this equation makes clear is that we must markedly improve the quality of healthcare in order to improve value. The adoption of the EHRs in clinical systems should help drive the quality agenda. But it’s important to recognize that EHRs alone may not be sufficient to deliver data intelligence, to really deliver data to clinicians in a meaningful way that will help them improve value.

David Burton, MD

Why the Solution to Population Health Management Woes Isn’t an EMR

Healthcare systems are struggling to figure out how to shift to a value-based model and remain competitive. This will require hospitals to identify and reduce waste in three categories: the variation in 1) the care that is ordered, 2) how efficiently that care is delivered, 3) in care delivery that causes preventable complications .Clearly, EHRs aren’t the answer. What’s needed is the industry-wide adoption of adaptive, clinical data warehouses capable of integrating disparate transactional source systems and analytical tools that can provide crucial actionable intelligence

Luke Skelley

Accountable Care Means Sharing Data Between Payers and Providers: You’ll Need More than an EHR

Accountable care is changing the way Payers and Providers look at their healthcare data. Many healthcare enterprises believed that their Electronic Health Record (EHR) would be the silver bullet to this data problem, but they are beginning to discover the limitations of the EHR for managing at the enterprise-level all of the information necessary for effective risk-sharing. Health information exchanges (HIEs) help eliminate data silos but are not designed to store or analyze the data with the level of sophistication required for supporting a risk-sharing model. The reality is, until now, providers and payers have lacked consistent incentives to share data.

Dan LeSueur

Texas Children’s Hospital Uses Healthcare Data Warehouse as an Alternative to EHR Reports

One of my clients, Texas Children’s Hospital, recently made tremendous strides in this data-driven journey. Getting data from their EHR in a timely fashion was difficult, time consuming and resource intensive. Now, with the proper tools in place, namely a healthcare enterprise data warehouse, a suite of healthcare analytics applications and a process for information deployment, they have shifted the cost curve to drastically increase the availability and usability of information.T CH used their healthcare enterprise data warehouse (EDW) to meet demands for EHR
data and reports, and slashed their reporting costs by 67%.