EHR “SWAT” teams: a physician engagement initiative to improve Electronic Health Record (EHR) experiences and mitigate possible causes of EHR-related burnout

Abstract

This case report describes an initiative implemented to improve physicians’ experience with Electronic Health Records (EHRs), and is one of several strategies within our organization developed to reduce physician burnout attributed to the EHR. The EHR SWAT Team—a 10-member team—with interdisciplinary representation from clinical informatics, pharmacy informatics, health information management, clinical applications, and project management, is a direct feedback channel for all physicians to express their EHR challenges and have their requests reviewed, prioritized, and fixed in a timely manner. Through in-person divisional meetings, we gathered 118 requests, 36.4% of which were related to re-education and 17% of which were quick fixes. Popular requests included keyword search functionality, minimizing freezing, auto-faxing and auto-save. Our brief evaluation of 46 physicians demonstrated that physicians were satisfied with the initiative, with 61.3% physicians reporting that it increased their proficiency in using EHR functionalities. Lessons learned from this initiative include the importance of buy-in from Information Technology (IT) and physician leadership, extensive physician engagement, and leveraging project management techniques for coordination. Next steps include measuring the impact of this SWAT initiative on EHR-related burnout through a post-intervention organizational wide survey and objective back-end usage logs.

Tackling the Burden of Electronic Health Record Use Among Physicians in a Mental Health Setting: Physician Engagement Strategy

“…As such, the SWAT team model, which mirrors other initiatives at the University of Colorado School of Medicine [ 28 , 29 ], overcomes this challenge by bringing together a collaborative team to discuss and identify a commonly agreed set of requirements for each issue. Our team-based intervention ( SWAT ) included assembling an interdisciplinary team of specialists including our CMIO; clinical informatics nurses and educators; and representatives from pharmacy informatics, health information management, clinical applications, and project management [ 14 ]. Through this intervention, we met with physicians from each of the seven academic divisions across our organization, collected EHR change requests, and prioritized them into four categories: (1) additional education, (2) quick fixes (<6 weeks), (3) future fixes (≥1 year), and (4) unable to address owing to technical or regulatory restraints.…”

“…Through this intervention, we met with physicians from each of the seven academic divisions across our organization, collected EHR change requests, and prioritized them into four categories: (1) additional education, (2) quick fixes (<6 weeks), (3) future fixes (≥1 year), and (4) unable to address owing to technical or regulatory restraints. In total, we gathered 118 requests (eg, including adding keyword search functionality, minimizing freezing, and auto-faxing) [ 14 ].…”

“…In this viewpoint paper, we describe our efforts to reduce EHR burden for physicians at a large academic mental health hospital in Canada. Building on our previously published studies focused on needs assessment, implementation, and evaluation of individual initiatives [ 4 , 14 , 15 ], this viewpoint shares the development and implementation of our overarching strategy. We discuss our Physician Engagement Strategy, which aims at identifying and addressing opportunities for EHR improvements at our site.…”

Overcoming Obstacles to Develop High-Performance Teams Involving Physician in Health Care Organizations

“…Organizational strategies to permit workflow redesign, improve communication, especially among clinicians and staff, and develop quality improvement projects to address clinician’s concerns can reduce physician burnout and work place dissatisfaction [ 105 ]. In some cases amelioration of a specific organizational stressor, for example the interaction with the electronic medical record, may alleviate some elements of physician burnout [ 106 , 107 ]. Organization-directed workplace interventions that improve electronic processes, programs aimed at restoration of positive emotions around work in health care institutions can reduce burn-out [ 108 ].…”

From Adfm: Amplifying Advocacy in Family Medicine

“…Family physicians can contribute to the development of new technologies such as artificial intelligence or advanced learning systems to strengthen primary care. 11 We continue to endure a syndemic that affects us profoundly in terms of health, social connections, and economics. COVID-19 disparities, the Black Lives Matter movement, police violence, and climate change have deepened our understanding of the extreme health and social inequities that disproportionately affect disadvantaged individuals and communities.…”