The right technology tools can help physicians more effectively manage their time, improve the bottom line, and focus on what matters most: patients.
Physician Burnout is a public health crisis that demands urgent action. A 2019 Harvard University report concludes that if left unaddressed, the worsening crisis “threatens to undermine the very provision of care, as well as erode the mental health of physicians across the country.” 1
Physicians today are frustrated with computer interfaces, burdened by piles of administrative tasks, haunted by quality improvement, and challenged to manage the shift from a fee-for-service to value-based reimbursement model. A 2016 study published in the Annals of Internal Medicine found that physicians spend just 27 percent of their time on direct clinical face time with patients and 49 percent of their time on EHR and desk work.2 That means for every hour physicians engage with their patients, they spend nearly two additional hours on EHR and administrative tasks.
With the strain on physicians and their patients caused by the growing shortage of physicians across specialties throughout the United States,3 time management is a vital skill for busy physicians.
Managing, sustaining, or growing a medical practice; obtaining Continuing Medical Education (CME) credits; seeing as many patients as possible; and managing administrative responsibilities can be a challenge. However, with the aid of technology, physicians can tackle many of their daily tasks, manage their time more effectively, and set out on a path to a healthy work-life balance. After all, leveraging technology to manage time is integral to any healthcare practice, as it may lead to better healthcare delivery and increased revenue.
The first step is to set goals. Many highly effective professionals, no matter their industry, use goal setting to help manage their time and keep priorities in order. Setting both short- and long-term goals can help physicians stay focused and make decisions about where and how they spend their time. Taking even minimal time to lay out and review goals on a regular basis can ultimately help physicians save time and feel more self-assured in their decision making.
Then, physicians should explore the benefits of leveraging today’s technology.
USE APPS FOR PRODUCTIVITY
Deloitte’s 2018 Global Mobile Consumer Survey found that across all age groups, Americans look at their phones more than 50 times a day. With a projection of 3.8 billion smartphone users by 20214, the app ecosystem is flourishing, and the upward trajectory is forecast to continue. Medical professionals have an abundance of options when it comes to choosing which apps will help them most; the Apple App store offers more than 2.2 million options and approximately 2 percent of all the active apps are medical-related.5
Mobile apps that are hospital-approved for clinical use can be helpful. The EPIC Haiku App helps doctors locate patients in the hospital, look up lab results, and check the OR status board. The Welch Allyn iExaminer, used with its Ophthalmoscope, turns the iPhone into a mobile digital imaging device, allowing users to view and take high resolution pictures of the fundus and retinal nerve in the eye. The app then allows users to store the pictures to a patient file or email and print them.
In an era when dictation has taken a back seat to templates and typing, Nuance’s PowerMic Mobile, helps make dictating more convenient. Specifically designed to enhance productivity, this app allows clinicians to use their smartphones as a dictation microphone at any workstation with Dragon Medical. It’s easy to use, and clinicians can spend more time with patients, capture notes while information is fresh in their minds, or catch up on clinical documentation from home.
When patient communication is hampered by language barriers, doctors can use MediBabble, a free professional-grade medical translation tool. The tool has an extensive database of translated clinical questions and instructions that allows doctors and other medical professionals to effectively communicate with patients across multiple languages. Once downloaded, the app requires no Internet connection to function; therefore, it works well in commonly shielded environments such as hospitals, emergency departments, and radiology suites.
IMPROVE THE PATIENT EXPERIENCE
Millennials and Generation Z are forcing substantial change in the U.S. healthcare system. The high expectations that these generations have for healthcare isn’t shocking, as they have integrated technology into every aspect of their daily lives. Afterall, Gen Z is the first generation of digital natives, born and raised at a time when virtually everything can be done online.
Millennials and Gen Z both welcome technological disruption and view it as a way to make things better, faster, and more efficient. They want on-demand healthcare choices and virtual doctor visits and believe the improved use of information technology is vital for the future of the healthcare industry.
Today, physicians can send automated alerts and reminders directly to patients’ mobile devices or via email. Not only does this help prevent appointment no-shows or cancellations, it helps satiate the need of Millennials and Gen Z to use technology within the clinic.
Most scheduling software is simple to use and helps ensure that patients show up on time and don’t wait for hours to be seen, while guaranteeing smooth transitions of daily appointments according to a previously set schedule. Reducing missed appointments also helps practices improve their bottom line.
Leveraging technology to successfully enhance a patient’s experience with something as simple as an appointment reminder can have a big impact. For example, the appointment reminder from AdvancedMD lets medical practices set up to three sequential and automated reminders to schedule a patient for a recall visit. Not only does it let the user set the patient’s language (English or Spanish), it also provides the option of communicating via text message, email, or voice. By automatically sending patient reminders for upcoming appointments, medical professionals can improve continuity of care and patient engagement.
Studies have shown that phone communication with patients reduces readmissions6 and increases patient satisfaction,7 but successfully connecting with patients can be challenging. With daily schedules completely booked, there is little time to call patients during working hours.
Unfortunately, doctors are less likely to call patients outside of the office, and if they do, patients are unlikely to answer calls from unfamiliar or blocked numbers. With the help of mobile apps like the Doximity Dialer, physicians can call patients from their personal cell phone and the patient will see the hospital’s office number as the caller ID. Doctors can make calls on the go and patients are more likely to pick up a call from a number they recognize.
AVOID THE FAX MACHINE
Thousands of medical students across the country had never seen, let alone operated, a fax machine until the day they entered a hospital as a medical student, according to a CNBC article.8 Faxing seems like an obsolete, mundane task, but healthcare has been much slower to digitize than other industries.
CMS Administrator Seema Verma has challenged the industry and developers to help make doctors’ offices fax-free by 2020. However, it’s not likely that we will see the demise of the fax machine anytime soon, given that it is HIPAA-compliant off the shelf, and digital communication is not. Even with the integration of EHRs, clinicians still need to fill out an average of 20,000 forms every year. Chances are every hospital’s fax machine will remain busy for the foreseeable future.
But for technologically advanced medical professionals who need to review a patient’s lab results while outside the office or who don’t want to wait on hold forever to do a prior authorization, there’s an app for that. eFax capability is included as part of the Doximity website and mobile app. Physicians can easily receive and send faxes from an iPhone or Android. Physicians, nurse practitioners, physician assistants, and pharmacists can utilize the HIPAA-secure eFax to electronically fax colleagues and sign documents using just a finger. The technology also allows users to attach images and documents for secure delivery, date and sign, and annotate documents, all on the go.
This technology helps medical professionals use their phones to fax when time is of the essence and they can’t afford to wait for a clunky hospital fax machine to send time-sensitive documents. By giving physicians a technology-enabled platform to collaborate and share findings more effectively, physicians not only are able to provide better care, but are better able to manage their time.
EARN CME CREDIT
A vital part of delivering the best patient care is staying current with the latest medical advancements and research. Physicians are required to document this activity by earning CME credits. Most states require a specific number of credits annually to maintain medical licenses, and many hospitals require a specific number of CME credits for their physicians to maintain privileges.
But earning CME credits can often fall to the bottom of the physician to-do list when juggling a heavy patient load, which subsequently leads to an end-of-year scramble to meet the requirement.
Physicians can attend costly out-of-state conferences or pay to watch dry clinical videos to earn credits; however, there are better options for medical professionals to earn CME credit and keep track of what they have earned.
For example, BoardVitals offers an option to complete all CME requirements by answering board-quality cases and questions from a mobile device and reviewing supporting evidence-based rationale. Users can stay updated on the latest medical knowledge, take an online self-assessment activity to test knowledge through case-style review questions, and earn CME credits throughout the process, which is organized by specialty.
The Mayo Clinic CME app allows attendees of select Mayo Clinic meetings to browse the speaker information and presentations. Slides are also available from select sessions. An in-app feature allows users to make notes on the presentation slides from a mobile device.
Another option is RealCME, which offers frequently updated interactive educational activities in various specialty topics. All completed credits are automatically tracked within the app and users receive a personal performance report every quarter with completed CME credits. The certificates are mailed directly to the recipient.
Podcasts may be more appealing for those who prefer listening to reading. ReachMD CME is an exclusive XM satellite radio channel that’s accessible on a mobile device. This resource allows medical professionals to listen to and take CME exams on a mobile device, while regularly being updated with new CME programs to browse by keyword.
A few other podcast-style options include: AudioDigest, which offers topical collections through a “playlist” approach, giving clinicians access to relevant and up-to-date lectures on issues related to leading medical challenges; JN Listen, an audio CME podcast app that collects interesting, relevant podcasts based on peer-reviewed articles published in JAMA; and Pri-Med, which features expert faculty discussing the most recent developments in the medical field.
THE RIGHT TOOLS
As physicians, our priority is to deliver the best quality care to patients. Technology that enhances clinical workflows, increases productivity, and improves patient experience is now more seamless than ever.
Whether it’s an app to schedule an appointment, conduct a telehealth visit, earn CME credits, or text a follow-up appointment reminder, choosing the correct tools can help physicians more effectively manage their time, help the bottom line for their practice, and have more time to focus on what matters most: patients.
Peter Alperin, MD, trained as an internal medicine physician at UCSF and is currently vice president at Doximity, where he leads the development of products geared toward clinicians. He also has had roles in product development with Archimedes and ePocrates and served as director of informatics with Brown and Toland Medical Group. He remains in active practice at the San Francisco Veteran’s Affairs Medical Center.
1. Jha AK, Iliff AR, Chaoui AA, Defossez S, et al. A Crisis in Health Care: A Call to Action on Physician Burnout. Waltham, MA: Massachusetts Medical Society, Massachusetts Health and Hospital Association, Harvard T.H. Chan School of Public Health, and Harvard Global Health Institute; 2019. http://www.massmed.org/News-and-Publications/MMS-News-Releases/A-Crisis-in-Health-Care--A-Call-to-Action-on--Physician-Burnout/#.XkGKHDFKiUk. Accessed February 10, 2020.
2. Sinsky C, Colligan L, Li L, et al. Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Ann Internal Med. 2016;165(11):753. doi:10.7326/m16-0961
3. Dall T, Reynolds R, Jones K, et al. The Complexities of Physician Supply and Demand: Projections from 2017 to 2032. 2019 Update. Washington, DC: Association of American Medical Colleges; 2019. https://aamc-black.global.ssl.fastly.net/production/media/filer_public/31/13/3113ee5c-a038-4c16-89af-294a69826650/2019_update_-_the_complexities_of_physician_supply_and_demand_-_projections_from_2017-2032.pdf. Accessed February 10, 2020.
4. Takahashi D. Newzoo: Smartphone Users Will Top 3 Billion in 2018, Hit 3.8 Billion by 2021. VentureBeat. September 2018. https://venturebeat.com/2018/09/11/newzoo-smartphone-users-will-top-3-billion-in-2018-hit-3-8-billion-by-2021. Accessed February 10, 2020.
5. Clement J. Apple: Most Popular App Store Categories 2019. Statista. https://www.statista.com/statistics/270291/popular-categories-in-the-app-store. Published November 25, 2019. Accessed February 10, 2020.
6. Harrison PL, Hara PA, Pope JE, Young MC, Rula EY. The Impact of Postdischarge Telephonic Follow-up on Hospital Readmissions. Popul Health Manag. 2011;14(1):27-32. doi:10.1089/pop.2009.0076
7. Braun, Eyal, Baidusi A, Alroy G, Azzam ZS. Telephone Follow-up Improves Patients Satisfaction Following Hospital Discharge. Eur J Intern Med. 2009 Mar;20(2):221-25.
8. Farr C. Fax Machines Are Still Common in Medicine—and Med Students Are Puzzled When Forced to Use This Ancient Technology. CNBC. https://www.cnbc.com/2018/02/10/milllennial-doctors-forced-to-use-fax-machines-causing-puzzlement.html. Published February 12, 2018. Accessed February 10, 2020.