Navigating healthcare is challenging, especially in an Ambulatory environment. With an increasing number of critically ill patients expecting convenience and compassion, and a declining healthcare workforce, the situation is less than ideal. In 2021, over 300,000 people exited the medical field, including 115,000 physicians, intensifying the healthcare workers and physicians' shortage. These facts underscore a challenging situation but also highlight a significant opportunity to address the inefficiencies in the healthcare systems operating model due to the imperative of staffing shortages.
Our healthcare workforce is incredibly passionate, purpose-driven, and caring - a crucial force for good in society, especially during crises like the COVID-19 pandemic. However, without effective systems for scalable care delivery, these individuals risk burnout as they strive to fulfill each patient's needs with a deep sense of personal responsibility and a lack of support in the operating model around them.
Current data indicates that clinicians spend almost 50% of their day on non-patient facing tasks, such as data entry, documentation, insurance claim processing, and other mandatory clerical work. This reality is unsustainable and unacceptable, given the increasingly acute shortage of healthcare professionals and its contribution to making work feel less meaningful, ultimately leading to burnout. We must all do better.
In Ambulatory Care at Duke Health, we are implementing various strategies to restore meaning to work and eliminate non-value-added tasks for our highly skilled workforce:
- Implemented AI-enabled virtual scribe services, improving quality of life and saving approximately two hours of documentation time per clinic day for over 150 clinicians.
- Developed an engagement center model in primary care and select specialties to manage inbound patient calls, portal messages, forms, medication refills, and prior authorizations, resulting in a 40% reduction in Inbasket messages handled by physicians, improved turnaround time, and enhanced patient and clinician experiences.
- Over a four year period, we eliminated non-value-added steps in the patient scheduling, registration, and intake processes, resulting in a 30% decrease in the time those tasks take to complete
- Automated processes such as outside medical record collection, insurance prior-authorization, patient referral scheduling outbound calls calls, and allowing patients to self schedule appointments to minimize staff time being used to transcribe already available data.
Unfortunately, the current systems and operating norms will render it impossible to meet patients' needs with the available clinicians and staff workforce. We have been actively changing our operating models since 2018 and have made significant progress. However, change is slow, progress is non-linear, and we, still have more to accomplish than we have achieved.
No work is more important for organizations employing our talented healthcare workforce. It is our primary duty as leaders in healthcare to remove barriers and maximize the meaning derived from providing compassionate, excellent, and high-quality care to the patients who depend on us.