October 6, 2022

The unprecedented challenges of the past two years continue to have a devastating impact on the health care workforce across the U.S. Providers and clinicians are overwhelmed, exhausted, and rapidly exiting the industry. According to monthly OCHIN Epic satisfaction surveys, the percentage of providers who report feeling burned out has held steady for the past year at 36%, or more than one in three.

Extra hours spent charting drive burnout

In addition to pandemic fatigue, high rates of turnover, and dwindling financial resources, one of the most cited challenges across the OCHIN network and health care industry at large is the increased after-hours charting workload—known as “pajama time”—that has resulted from an ever-changing landscape of new technology, compliance, and billing requirements.

An OCHIN analysis of pajama time revealed that OCHIN providers spend an average of four hours on charting activities outside of normal work hours. Adult nurse practitioners experience the highest strain, with an average monthly pajama time of 7.6 hours. Physicians are strained, too, averaging an additional 6.8 hours of charting per month.

Mental health providers saw the greatest year-over-year increases in pajama time from 2019 to 2022, with behavioral health specialists and licensed mental health counselors seeing increases of more than 130%.

While accurate patient records are necessary for care team coordination, improved health outcomes, and accurate financial reimbursement, the process should be more streamlined for providers.

National health IT standards can improve care and relieve burden

Burnout leads to turnover and instability that can negatively impact care delivery. Designing better health IT that improves user experience (UX) and reduces implementation challenges for providers can help reduce burnout and drive more equitable health outcomes for patients.

National digital data and technical standards can reduce complexity in the system, streamline clinical workflows, and decrease EHR training time. They can also reduce the amount of documentation required when federal and state government programs have different data reporting requirements, which enhances ease and efficiency for providers.

That is why OCHIN is a founding member and supporter of the Health IT End-Users Alliance, a group focused on ensuring that policy and standards development activities reflect the complex clinical and operational challenges facing health care technology users. The Alliance will establish priorities for how technology should support clinical care and operations and work toward reorienting the conversation to start with the needs of the patient and their care team.

“OCHIN is pleased to join our partner organizations in this vital work to build more connected care communities and drive inclusive health care innovation,” said Jennifer Stoll, executive vice president of external affairs at OCHIN, in a recent statement announcing the creation of the Alliance. “The consensus statement released today highlights the importance of ensuring the voices of providers and patients from rural and underserved communities are included at all stages of the standards development and testing process.”

Designing better systems will help meet future challenges

Today’s health care workforce is experiencing many pressures that can be eased through implementing national data and technical standards to drive equity and build resilience for the future. For example:

• Improving public health reporting and infectious disease monitoring at the regional, state, and federal levels

• Enhancing patient safety by ensuring a single, accurate patient record without duplication

• Reducing bias in the development of health care artificial intelligence (AI) by ensuring quality and representative data is used to train machine learning algorithms

At OCHIN, addressing these challenges to ensure the future viability of our country’s health care system, while expanding clinical capacity for the road ahead, is a top priority. OCHIN’s Clinician Burden and Clinical Complexity committee, created in 2022, is continuing to review member feedback data and proactively identify new ways to further reduce the administrative and technical burdens facing care teams.

Creating more representative national health IT standards and solutions is essential because it will improve both care and organizational effectiveness without adding to provider burden. For health IT to improve health care for both patients and providers, it must be developed with the needs of health care professionals in mind and reflect their real-world experiences so they can focus on what they do best—providing high-quality care.