Overwhelmed Employees and Burned-out Clinicians: The Shared Causes and What to Do About It
What’s causing burnout in healthcare and making employees feel overwhelmed more generally? To answer that question, allow us to borrow from the famous political quote from James Carville: “It’s the technology, stupid!”
Our continued reliance on technology to build greater productivity, engagement, and success has instead been failing us. More specifically, failing our people, our workers, our caregivers, and our clinicians.
Let’s start with healthcare.
The decade-long inundation of technology in the form of electronic health records (EHRs) and other administrative IT has placed a massive burden on clinicians, administrators, and patients. Have we improved healthcare quality or improved the patient experience with all the technology investment? Are patients or providers singing the praises of all this investment? Hardly.
Just recently, The Department of Health and Human Services (HHS) released a report, “Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs,” which admits in stark terms the misplaced burden health IT and EHR has placed on clinicians. The report was a joint effort among HHS, ONC, and CMS.
In a follow-on statement, CMS Administrator Seema Verma said, “The taxpayers made a massive investment in EHRs with the expectation that it would solve the many issues that plagued paper-bound health records. Unfortunately — as this report shows — in all too many cases, the cure has been worse than the disease.”
 HHS Finalizes Strategies to Combat EHR Clinician Burden. EHR Intelligence. Feb. 24, 2020. https://ehrintelligence.com/news/hhs-finalizes-strategies-to-combat-ehr-clinician-burden
What about the rest of the work world?
The phenomenon of burnout extends well beyond healthcare. The World Health Organization (WHO) now recognizes burnout as a syndrome resulting from “chronic workplace stress that has not been successfully managed.”
Add to this the mounting evidence of the recurring downside of technology and the burden it creates across the world of work.
- Just a few years ago, the average U.S. worker was reported to spend 25% of their day reading or answering emails.
- Now in 2020, “Slack-lash” is a thing, described as, “the growing unrest among workers” dealing with “interruptions that take their attention away from the task at hand.”
- Globally, 61% of people agree that the pace of change in technology is too fast.
For the record, I’m no luddite. I’m writing as a former clinician and a current technology entrepreneur, and I’ve consulted for years with consumer technology companies to apply theories of human motivation in how they make their products.
In short, I have an all-in commitment to fulfilling technology’s promise to make things better. When it fails to do so, the researcher in me rolls up his sleeves to find effective answers. Here are key questions I’ve learned to ask, alongside practical answers on how to fix this.
Question 1: Who are we building technology for?
Every product designer gets to this question early because it determines everything that follows.
EHR — for all its good intentions — was not built for clinicians, but rather providers and payors. From the HHS report mentioned previously:
In an EHR system, there may be instances where the workflow reflected by a particular EHR does not mirror the clinical environment. In these instances, end users are often forced to alter their clinical workflows to align with an EHR system’s workflow. This can lead to frustration and increased burden, and sometimes results in less-efficient clinical care.
Likewise, in the world of enterprise technology, much of the focus on “employee experience” and making work “more human” arises from the recognition that we’ve been burying people with technologies that were not built with their needs in mind.
 Josh Bersin and Deloitte Human Capital Trends.
 Google Backs Productivity Startup Building Algorithmic Inbox for Slacks, Emails, and Texts.” TechCrunch. Feb. 11, 2020. https://techcrunch.com/2020/02/11/google-backs-startup-building-an-algorithmic-inbox-for-slacks-emails-and-texts/  Edelman Trust Barometer 2020.
 Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs. The Office of the National Coordinator for Health Information Technology. February 2020.
By failing the people technology most needs to support and serve, its adoption and success have been predictably poor: Forty-two percent of cloud HCM projects were rated as not fully successful or failed after just two years. That’s a lot of frustrated people and a staggering amount of money down the drain.
Question 2: What do people fundamentally need?
I’ll summarize here what I’ve shared in a prior post, about one way we can approach answering this critical but often unanswered question.
Simply put: The world’s best product designers have learned to apply Self-Determination Theory (SDT) so that technology truly fulfills the needs of the people that use it. It’s time healthcare did the same, not only because it guides good technology design, but because SDT is implicitly an evidence-based model for well-being itself.
Each month, thousands of research and commercial publications cite the insights of SDT based on its 40-year history of empirical evidence into what matters. The reason why is simple: This model unlocks the keys for motivation and engagement that drive performance, satisfaction, and well-being.
Specifically, SDT demonstrates that when people fulfill their basic psychological needs for autonomy, relatedness, and mastery, they will do their best work and feel vital in the process.
Question 3: What can we do about it?
Many billions of dollars and years of effort have been spent to give us the technology we have in healthcare and at work. Suffice it to say, it’s a long-term effort to improve the work experience and technology’s role in it. To unlock the potential of technology to truly fulfill its promise, we need to refocus on caring for those who use it and put the needs of caregivers back into a central role.
We can start now. We invite everyone in to help lift the burden, and combat burnout, by making technology built specifically to support the needs of employees and clinicians a cornerstone of our approach.
We’ll cover this topic in greater detail in an upcoming webcast. I invite you to join us on April 1 at 2 p.m. EDT to learn how Self-Determination Theory surfaces the causes of overwhelmed employees and burned-out clinicians, and offers a solution to help you do something about it: CLICK HERE to register.
 Josh Bersin. HR Technology: The Dirty Little Secret. Deloitte Human Capital Trends 2019. https://joshbersin.com/2019/11/hr-technology-the-dirty-little-secret/