Notable’s State of Automation Analysis 2022, Part 1

Healthcare professional perspectives

Our new annual State of Automation Report was established to benchmark the attitudes of healthcare workers toward technology and automation. The survey was conducted by OnePoll on March 3-5 and had 1,005 respondents, who ranged from medical assistants and nurses all the way up to executives and administration, working at healthcare organizations with at least 50 employees.

Overview

• The complex lattice of repetitive, manual tasks is overburdening an already stretched workforce, harming patient care, and holding back the healthcare industry.
• Our findings in the first annual State of Automation Report confirm the urgency of eliminating these manual tasks to allow the industry to move forward.
• The majority (57%) of respondents are personally worried about burning out due to the high volume of repetitive tasks they must complete.
• 48% are worried about their organization’s ability to retain and hire staff if they do not prioritize automation.
• But respondents are not just worried for their own sake — 54% of respondents believe that the complexity of our healthcare workflows has a negative effect on patient care.
• Though many organizational promises about technology have previously fallen short, 81% of respondents feel hopeful that technology can help improve their experience as healthcare professionals.

A case for urgency

Notable’s original research adds to the long list of surveys, studies, and articles from the past few years showing upsettingly high burnout rates among healthcare workers. These rates are particularly worrisome when noting that these are the remaining cohort after half a million workers left the workforce last year.

The need for change is paramount. 48% of staff believe their organization is not doing enough for employee burnout. But respondents are not just worried for their own sake — the complexity of healthcare workflows is also harmful to patients. Staff wrote about negative patient outcomes, including death, due to being short-staffed relative to patient volumes while having to keep up with a huge administrative burden using outdated technology.

Reading staff’s first-hand accounts of the pressures placed on them and the obstacles to being able to effectively care for patients is alarming. And thus far, many of the promises made by organizations to use technology to improve their employees’ experience have ultimately failed and in fact, may have made things worse. A survey conducted over the course of 2020 to Q1 2022 by KLAS showed a strong association between dissatisfaction with the organization’s EHR and the likelihood of attrition.

The report states: “Among clinicians who strongly disagree their organization has implemented, trained on, and supported the EHR well, more than one-third say they are likely to leave their organization in the next two years — a larger proportion than any other clinician cohort.” Additionally, clinicians who were very dissatisfied with the EHR were almost three times more likely to leave their organization compared to clinicians who were very satisfied with the EHR.

Thankfully, there is hope. 81% of respondents believe that technology can help improve their experience as healthcare professionals. No matter their age, gender, or region, the majority of respondents across all demographics are optimistic that technology can be leveraged to help them.

The following article further breaks down our survey results, describing staff pain points, as well as outlining steps to take to move forward.

Repetitive tasks are burning staff out

On average, respondents believe that 57.5% of staff time at their organization is spent on repetitive tasks such as data entry. When we ran a poll on LinkedIn to compare with the survey data, our LinkedIn respondents were in agreement: the largest group of them (47%) believed that somewhere between 50-74% of healthcare time is spent on repetitive tasks such as data entry.

Staff who are in direct patient care roles (a sample size of 540) believe that, on average, 32% of their own time is spent on tasks unrelated to patient care. That time is significant, particularly during the labor shortage when there are simply not enough staff for patient volumes.

In fact, mentions of being short-staffed or under-staffed occur at least 139 times in 510 written responses to a question about obstacles to meaningful work. One respondent wrote in, “I work in the ICU. During the pandemic, we have worked short-staffed and are still expected to spend the same amount of time on charting for each patient. This has resulted in sacrificing time with patients.”

The additional demands of charting, on top of high patient loads, are a source of stress for staff. 57% of respondents are worried they will personally burn out due to the number of repetitive tasks they have to complete, and 28% of respondents have already quit a healthcare job due to burnout. These concerns about burnout due to repetitive tasks are not limited to any one generation, region, or role.

The majority of Gen X, Millennials, and Gen Z are all concerned about burnout. Millennials, however, are more worried about burnout than the general population — a total of 63% of Millennials are personally worried they will burn out, and are more likely to have already quit a healthcare job due to burnout (34% of Millennials, as opposed to 28% of the total pool of respondents). This is worrisome, as Millennials make up over a third of the workforce. A study by Health Affairs confirmed that nurses under age 35 are more likely to quit. This could have a generational effect on the healthcare workforce, as nursing tends to be a lifelong vocation.

When broken down by role, 63% of clinical staff are worried they will burn out, as opposed to 55% of non-clinical staff. A study by Duke University states that rates of potential moral injury in healthcare workers over the past few years of the pandemic are comparable to those of combat veterans after 9/11, and measures rates of burnout at over 50% of healthcare workers.

Staff’s written responses illustrate this exhaustion and disillusionment. One staff member wrote, “I was distracted by how tired I was and I considered why I went into the field. So short-staffed with poor management and leadership.” Another wrote that being unable to focus on meaningful work is a daily problem for them, and then followed the statement simply, “Burn out,” as though they were too exhausted to further elaborate.

And once workers have hit this point, having burned themselves down at both ends, even simple tasks feel insurmountable. “The burnout really makes you lose focus and interest in the work no matter the complexity of the task,” one response reads. Staff are in critical need of relief. To disregard burnout — and its causes — would be to continue losing healthcare practitioners, with a detrimental impact on care delivery to be seen for years to come.

Patient care is suffering

But health systems don’t have to wait several years before seeing this impact. Per healthcare staff, patient care is already suffering. 54% of respondents believe that the complexity of our healthcare workflows has a negative effect on patient care.

Those working in direct patient care are about 5% more likely to think that healthcare complexity is harmful to patient care than non-clinical staff. One staff member wrote in, “A patient's medical work was messed up and it took hours to update and get the right information.” While, thankfully, this issue was ultimately resolved, these kinds of delays and miscommunications can be very harmful. In another story from healthcare staff, there was a much more dire outcome:

“A patient’s admission med list and orders were incorrectly documented due to an immense admission load. By the time the error was discovered the patient was found in a diabetic coma and later died at the hospital. Had the admission assessment been done in a timely manner when the day shift wasn’t so busy with an insane amount of required paperwork, the DKA would have been noted and treated immediately and not 8 hours later.”

Mistakes cost time, and the more complex the workflow, the more likely staff are to make mistakes. As a result, patients face worse outcomes.

The complexity of healthcare workflows can also reduce the amount of time staff have available to spend on patients. 45% of respondents are frustrated by how little time is being spent on patient care. Impassioned written responses from staff show a strong disconnect between their own personal priorities and what they believe the organization’s priorities to be. They attribute their lack of time for patients to wrongly assigned organizational priorities that don’t align with their values:

• “It’s always go go go there’s no time for compassion and caring it’s all money money money.”
• “My last employer had too many demands that had nothing to do with active patients, not enough staff or time in the work day.”
• “Too busy with nonsense to focus on patient care.”
• “I don’t give patients the attention they deserve, my hands are tied when it comes to helping them more, I am unable to go above and beyond.”
• “The entire point is to take care of patients, not to spend our time on administrative tasks.”
• “I get frustrated when administration is prioritizing documenting and record keeping over direct patient care.”

For staff to feel they are being held back from adequately caring for patients is tragic. There is a significant need for quality patient care, and staff should be enabled to provide it.

Automation offers hope

Previous technology implementations have not always gone smoothly. When EHRs were first rolled out, the promise of technology was that it was supposed to make things easier, that patients were supposed to be able to access care anywhere and staff would be able to pull up their records in the blink of an eye. Instead, interoperability remains a challenge, the systems that staff use are not user-friendly, and additional manual work was generated.

With this in mind, we asked staff to evaluate their organizations on a few key measures. The first was whether they believe their organization is using digital technology effectively. We found a 44% discrepancy between executives who strongly believe their organization’s use of technology is effective (71% of executives) and everyone else (27% of general respondents). When we asked whether new technology implemented at the organization had helped reduce their workloads, answers were divisive. 52% of respondents report a reduction in their workload due to technology, while 41% say new technology has not helped reduce their workloads.

There is, of course, a broad range of technology available on the market, some more effective than others. Some respondents wrote about outdated technology interfering with their work: “Technology is outdated and I could not get my work done.” Others wrote about how glad they are that their organization uses automation: “I have been frustrated on jobs by repeatedly doing tasks in the past without automated technology. Now that we have it I enjoy my job a lot more.”

Previously, automation was seen as intimidating for workers, as a potential threat to jobs. It seems the stressors of the pandemic have accelerated interest in and acceptance of automation. 48% are worried about their organization’s ability to retain and hire staff if their organization does not prioritize automation. It seems automation is no longer seen by workers as a source of fear, but as a source of much-needed support.

Staff members suggested that not using automation is equivalent to wasting human time and labor. One respondent wished their organization had used automation to help fill out repetitive forms: “One day during the last month we had to complete a lot of forms for some medical research and it would be so much easier if our clinic would have more automated administration tools. So, we lost precious time.” Another respondent summarized: “Fixing human errors is wasting time.”

Time is in short supply, and energy is perhaps even scarcer. 48% of respondents believe their organization is not doing enough to help with employee burnout. “Health care professionals are burnt out and never feel appreciated,” a survey respondent wrote. Still, healthcare staff are dedicated to their patients and want to keep doing good work.

Overwhelmingly, staff are optimistic about the potential of technology to help them. 81% are hopeful that technology can improve their experience as healthcare professionals. Automation offers the possibility of taking menial tasks off the plates of healthcare workers and giving them several hours back in their days to focus on patient care or rest. It also reduces the chances of making documentation mistakes that can lead to negative patient outcomes.

Given the rates of staff burnout, given the negative patient outcomes, there is no more crucial time to start automating to provide relief and unlock extra capacity.

Next steps

At Notable, our philosophy is that using intelligent automation counters the complexity and fragmentation of the healthcare ecosystem. Digital assistants can perform manual work on behalf of staff and clinicians, and patient engagement technologies ensure patients are connected to care when and where they need it.

Our platform seamlessly integrates with the EHR, eliminating downstream work. Health systems using Notable can operate with the personalization, precision, and simplicity required to reach their strategic goals.

We recommend taking the following steps to learn more:

• Learn about Notable’s platform. Notable offers a comprehensive platform. This brochure should provide a sense of the breadth of our offerings.
• Learn what our customers are saying. Notable is highly trusted by our health system partners. Our video with Castell shows how automation saves staff time and improves population health. Check here to read additional stories about how Notable is delivering value to our partners.
• Request a demo. Schedule time for us to show you what we do, answer any questions you may have and make recommendations about how to move forward.