Revolutionizing healthcare: Navigating the challenges and innovations of 2024
With burnout and staff shortages afflicting the industry, more organizations are exploring the synergy of technology and care to boost clinician experience.
Clinicians need help, and healthcare organizations are hearing their pleas – if only to ensure that they can continue to provide quality care to patients.
The data on the crisis has been there for years. For example, in January 2023, the overwhelming sense of the challenge was encapsulated by the title of new survey-based report published in Medscape – “I Cry but No One Cares.”
Burnout is just one symptom of the erosion of clinician and staff experience; it was added to the Triple Aim nearly 10 years ago because of the importance of caregiving personnel to achieve any of the others of the Triple Aim. Burnout and other issues that affect caregivers “thus imperil the Triple Aim,” declare Thomas Bodenheimer, MD, and Christine Sinsky, MD, in their seminal article that notes that “care of the patient requires care of the provider.”
With the stresses of the COVID-19 pandemic behind the industry for now, the need to reverse trends and improve the experience of those instrumental in patient care will gain increasing prominence in 2024 and beyond.
No single solution, but executive leadership is key
Improving clinicians’ lot in life is affected by many factors. A key finding in research indicates that senior executives, casting their strategic visions, are crucial to pursuing the wide-ranging initiatives critical to improve all components that combine to make caregivers’ lives better.
While technology can play a role in improving clinician experience, it still must fit into other, broader efforts that address the whole of what doctors, nurses and staff are facing in their day-to-day lives.
Organization CEOs are looking for ways to mitigate economic and demographic forces to both find and retain clinicians and hospital staff. Tom Mee, CEO at North Country Health, a system based in Bethlehem, N.H., is heading an initiative to retain and engage those who are hired through a unique Lean Six Sigma program. Other executives are looking at steps they can take to maintain staffing levels and patient care objectives.
Technology providers and healthcare organizations increasingly will be looking for solutions that provide a “soft” payback, such as reducing workloads, handling mundane tasks, increasing efficiency in finding patient data and medical information relevant to a case, and offloading tasks that can be automated.
Clinical staff “are stressed, they're tired, they're really burning out,” says Michelle O’Connor, president and CEO of MEDITECH. “Technology is going to be something that assists them.” For example, MEDITECH has been incorporating Google search and summarization with Google “for just about a year now. And I think that's the first step that we're going to take and help with AI, enabling clinicians to find information in the record much quicker, much smoother and show it (longitudinally).”
As clinician shortages continue and it becomes harder to find other personnel to staff healthcare organizations because the country is at nearly full employment, healthcare organizations will need to become focused on hiring and retaining talent in 2024.
Can artificial intelligence begin to make life easier for clinicians?
Technology has a bad rap with clinicians – it has added significant levels of documentation work on computers. It’s made professionals feel like they are detail-bound functionaries who are tasked with getting enough information to merit the claims submitted to payers.
There’s a growing body of evidence that current technology and its role in care delivery is adding to clinician burden and is a major factor in clinician burnout. Not surprisingly, provider organizations are looking to technology to augment care workers, providing a return on their investment of time and effort to use records systems.
But there’s growing efforts to use technology to help clinicians and relieve workloads. For example, technology providers are looking to include advanced search capabilities to enable clinicians to find information in patients’ medical records or in online searches.
Also, there’s growing hope that artificial intelligence and other advanced capabilities can reduce mundane and clerical work from clinicians. For example, MEDITECH is looking to use listening technology as a “digital scribe,” which could redefine the process of creating and approving clinical visit notes. Further, MEDITECH is partnering with Suki and may work with other ambient listening vendors to facilitate time savings and work reductions.
A recent roundtable discussion by LeanTaaS featured Charles Harr, chief medical officer of WakeMed Health and Hospitals, and Cheri Cartwright, system vice president of surgical services at Lee Health, involved a discussion of how artificial intelligence and machine learning technology advancements offer the ability for providers to spend more time with patients and get back to the reason they joined medicine, humanize technology and unlock capacity.
Wider data and deeper analysis also is expected to help. For example, The University of Texas MD Anderson Cancer Center announced its Institute for Data Science in Oncology (IDSO) will bring together top data scientists with leading clinicians and cancer researchers to revolutionize how MD Anderson leverages data to fuel new discoveries, optimize the patient experience and personalize cancer care. Results from this research will trickle down to other clinicians treating cancer patients.
In light of growing burnout and staffing shortfalls, 2024 will be a crucial year to advance these technology paybacks.
Interoperability’s potential to reduce clinicians’ burden
There’s growing optimism that the Trusted Exchange Framework and Common Agreement (TEFCA) will make widespread interoperability a reality. In January 2022, the Office of the National Coordinator for Health Information Technology (ONC) and The Sequoia Project released the Trusted Exchange Framework and Version 1 of the Common Agreement. One year later, six organizations became candidate Qualified Health Information Networks (QHINs) and committed to complete “onboarding” and “go live” by the end of 2023, expected to be formally announced in mid-December.
The Common Agreement has recently been updated to Version 1.1 in preparation for data sharing through TEFCA. The updated Common Agreement includes specific technical and clarifying changes and will be accompanied in short order by updates to the QHIN Technical Framework, FHIR Roadmap, and standard operating procedures.
Even as interoperability capabilities improve, much work still remains to be done. Capabilities are growing through the use of the Fast Healthcare Interoperability Resource (FHIR) standard, which can facilitate the exchange of health data. Multiple “accelerator” initiatives are underway at HL7, which seeks to embed FHIR-aided coding in use cases that support the exchange of data in areas such as provider-payer data exchange, oncology treatment, medical research, social determinant information and more. These efforts are expected to improve information access by clinicians and reduce administrative burdens.
For its part, ONC has committed to have TEFCA support FHIR-based exchange because API scalability needs TEFCA.” The second version of the Common Agreement, which is under development and expected to be published in the spring, will include participation enhancements and technical updates to require support for FHIR-based transactions within 2024.
More interoperability impetus will come from organizations boosting FHIR. For example, the eHealth Exchange is launching an incentive program to accelerate HL7 FHIR adoption, that recognizes the technology and labor investments required within the healthcare ecosystem to adopt networked FHIR.
Also, Renton, Wash.-based Providence has announced the health system is the first in the country to build a FHIR driven data-as-a-service product that facilitates the exchange of clinical data between providers and payers. The organization says the systemwide standardization of clinical data will ease the delivery of value-based care to patients in a way that alleviates administrative and financial burdens. This will likely have downstream benefits for clinicians, who will see downstream benefits from reduced administrative work.
There’s so much that needs to be done with interoperability that can be done to improve clinicians’ well-being, and the industry needs to turn up the heat in 2024.