Date night with the EHR (from the VP of Joy)


This is both impressive work and incredibly depressing, and is a clarion call for those in physician informatics. Dr. Christine Sinsky’s piece in the NEJM catalyst is called “Date night with the EHR” and very clearly delineates physician time spent charting in electronic health records. Particularly appalling is the time spent on WEEKEND evenings (red circle) reliving the past week’s worth of left-over work. It is a clear dagger into the heart of physician wellness and key manifestation of physician burnout.

It is for this reason, that Practice Efficiency efforts with EHR optimization Sprints as well as Care Redesign by re-configuring clinical teams in clinics are gaining traction. It is for this reason that hospitals and clinics are taking a hard look at improving their Culture of Wellness. It is for this reason that organizations are investing in Physician Resilience programs.

And, the American Medical Association now has a Vice President, Professional Satisfaction, or as Dr. Sinsky calls herself: “The VP of Joy.” what an awesome title.

CMIO’s take? It is about time. Could this be the inflection point where silently suffering physicians begin to see hopefulness on the horizon? Physician Informaticists have long been at the bleeding edge of this work and the cultural traction is gratifying. March on, colleagues!

CT meditates: a comedy (5). Three domains of physician well-being


So, lets get this clear. I have heard both sides of the debate about “Physician Wellness Programs are Lipstick on a Pig“. Yes, of course. Many physicians are burned out because of inefficient practice, and often it is due to the setup and requirements of the Electronic Health Record. Therefore, according to this contingent, recommending ANY physician wellness program is like saying “suck it up; here’s some candy; hope you forget that your EHR sucks.”

In fact, in my organization, I have heard the sentiment: “CT Lin is personally ruining the quality of care at our organization” and also “SOMEONE (maybe CT) caused this dictation outage“. He just wants us to TYPE in the damn EHR.

On the other hand, I very much like the tripartite chart shown above: Physician Wellness can be described as three interrelated things: Personal Resilience (that CAN be improved with Wellness programs, and meditative practice, as I’m embarking on this month), Practice Efficiency (that I have and will continue describe our Sprint efforts and Care Redesign efforts), as well as a Culture of Wellness (where hospital and medical leadership – see my last post- emphasize how we will work together, and seek constant improvement).

Remember: those coming on the journey: 3 minutes of meditation! I’m holding both of us accountable to this important habit!

CMIO’s take? Don’t take it personally. It is both a meditative practice, and good career advice for a CMIO. I am a personification of this principle.