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Five reasons why your facility’s technical debt could be contributing to staff fatigue and poorer performance


Healthcare is no stranger to burnout, just like IT decision-makers are no strangers to the sector’s technical debt. But could suboptimal data practices be affecting your staff more than you think?

In late February this year, The Guardian reported that a record number of more than 400 workers in England left the NHS every week, largely due to burnout. Besides the obvious concerns this exodus raises over the quality of care, it calls for a deeper dive into the challenges staff face on a daily basis. And are we jumping to conclusions too quickly by blaming it all on the pandemic?

There are clinical challenges, and then there are administrative ones. Neither should be underestimated. While staff shortages remain the indisputably most cited cause for staff taking early retirement or seeking other careers, discrepancies in digital maturity across the sector cannot be ruled out as a contributing factor to a widespread disenchantment with the prospect of pursuing a career in healthcare.

We have more advanced technology than ever before, and yet clinical and administrative staff struggle to stay on top of their document management game, with repetitive tasks taking up more and more of their time, and keeping them from focusing on their patients and capturing their full story. Repetitive tasks, and a shortage of time to perform them, often lead to growing backlogs. Ultimately, this can lead to documentation time taking precedence over appointment time. A decrease in visit volume usually follows suit.

Does this sound familiar?  When you throw a pandemic and a significant tech lag into the mix, could automation be the easy fix?

  1. Your medical communication is not optimally centralised

Technology works both ways: providing clinicians with numerous ways to communicate can easily wreak havoc in the system. Amidst emails, secure messaging channels, digital health app alerts, paper mail and good old fax, there is enough room for critical information to fall through the cracks and lie forgotten in someone’s unchecked notes.

The latter is, most certainly, a worst-case scenario. What usually happens is that reminding oneself to check the right inbox and to use the recipient’s preferred sending method (while staying on top of strict regulations for the exchange of health data) adds up and weighs on the practitioner’s mental load. And that is no small matter.

  1. There are few interoperable remote monitoring solutions

Emphasis put on the shift to outpatient care depends on facility-specific factors, such as resources available, including technological resources. Regardless of your facility’s specific strategy on this matter, thought leaders across Europe and the US appear to agree that a switch to a model that encourages self-management can only be beneficial.

And if proof points are needed, the 6,500% increase in views of digital health libraries by NHS staff since the beginning of the pandemic speaks for itself. Similarly, ORCHA’s consumer studies indicate that the overwhelming majority of individuals approached would be willing to use digital health apps as a means to avoid unnecessary visits to the hospital. And a whopping 90% of regular users were satisfied with their experience and with being empowered to manage their own health and well-being in their own terms, from the comfort of their own homes.

In order for this care model shift to happen, though, tools need to be made available. Technology needs to scale so it can achieve a greater impact. The entire care system needs to accommodate a new form of patient follow-up and care, from partnering up with the right technology editors, to ensuring data safety and a seamless data flow with facility legacy systems.

  1. Existing digital solutions add an extra layer of complexity

Our experience in facilitating the deployment of digital solutions confirms a frequent concern: third-party solutions, as life changing as they might be, can end up placing an extra burden on staff. If they’re not interoperable and seamlessly integrated into existing systems, they will require input in the form of patient data, and output in the form of generated data being transferred back to the facility’s records. All in all, staff are faced with an extra task that can consume a significant amount of time and that opens the door to all kinds of bureaucratic mistakes.

A simple input error in a patient’s name or birth date can lead to a series of issues down the line: the individual cannot be matched to an existing patient in a facility’s Patient Administration System, requiring staff to perform multiple searches using different criteria until they pinpoint the issue. A patient not being found at the first try is also one of the main explanations for a pullulation of double entries.

As more and more double entries are created, medical data might be associated with one of them, but not the others. Hence, critical information might be lost somewhere in the pipe system, leading to less informed diagnoses, poorer care coordination and concerning breaches in identity monitoring protocols.

  1. There are digital literacy deficiencies that need to be addressed

Following the rollout of an EHR and/or document integration solution, or even a digital health one, protocol dictates that all staff be trained to use the new electronic systems. However, several factors appear to hamper even adoption of such applications - the staff’s age range, level of trust in the security and reliability of electronic systems, user-friendliness and the sufficiency of such training are all aspects that can either hamper or boost user adoption.

Some ORCHA studies appear to indicate that healthcare staff that are not proficient in digital health app usage are less likely to recommend such solutions to their patients. Our own experience as interoperability specialists also highlights the fact that user registration and generated data extraction, if complex and time-consuming, also hamper user adoption of such technologies - and, not surprisingly, healthcare staff, as opposed to patients, are more likely to drop the solutions in favour of other methods if their usage requires extra administrative work.

  1. Your patient records are not optimally centralised

Tim Ferris, director of transformation at NHS England, stated that circa 20% of acute trusts still don’t have an EPR. Of those that do have one, the Healthcare Data Institute estimates that 80% of their data assets come in unstructured form. And as for facilities that automate the structuring and integration of their data into their system of record, they represent an even smaller percentage.

Data is ubiquitous. But that is not the only issue - the real challenge is that data keeps growing. And growing. And then growing some more. According to RBC, today, approximately 30% of the world’s data volume is being generated by the healthcare industry. By 2025, it is expected to reach 36%. With the advent of IoMT, the data generated by all kinds of devices, including wearables, will grow exponentially!

It is largely assumed that with such a plethora of available health information, clinicians will be able to make sense of everything in their heads. This is not always the case. The human attention span is limited, and so is a practitioner’s time - it is essential that records are centralised, available immediately to those who need access to them, and as up-to-date as can be. More often than not, lives depend on them.

Lucy Chambel

Lucy is a writer, media specialist and proud polyglot. She is passionate about innovation, linguistics, and art.

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