Lessons Learned: How Digital Tools Can Help Address Healthcare's Workforce Shortage
Overview:
Since we have written approximately 75 Our Takes in the last two plus years we thought it might be helpful to take some of the summer to look at “Lessons Learned” from our posts. As such, this summer we will be looking at our lessons learned on the broad range of digital health on topics we’ve written about including Artificial Intelligence; RPM and Virtual Care; Value-Based Care, and Mental Health (among others). This week we look at how digital tools can help mitigate issues such as workforce shortages, burnout, and limited interdisciplinary training among physicians.
Background:
The shortage of clinical workers in healthcare is a major problem for health systems in the United States. Given the stress of long hours and increasing administrative burdens, combined with the additional shortages and tensions brought on by the Pandemic, worker stress and burnout are running at all-time highs. However, the pandemic also demonstrated the value of digital technologies like wearables, telehealth, remote patient monitoring, and scheduling apps in leveraging existing clinical staff to operate more efficiently and to serve more demanding patient loads more effectively. These changes will not come without their challenges. Nurses and physicians who are at the forefront of implementing these technologies have experienced difficulties in adapting to this new normal in terms of acceptance and training in the use of the technology. Encouraging active engagement by nurses and physicians as well as administrative staff in the realm of technology development and implementation is fundamental for improved performance of these innovations. Moreover, cross-training staff in the use and application of these new technologies can reduce time spent on administrative tasks and increase time spent treating patients.
This digital transformation of patient monitoring empowers clinicians to observe, report, and analyze patients' acute or chronic conditions in real time regardless of location. Remote patient monitoring allows healthcare providers to monitor and capture health data from patients for assessment and feedback. Utilizing these digital outputs allows physicians and care teams to get real-time insights into a patient’s status thereby facilitating early intervention, and reducing avoidable hospitalizations, and unnecessary trips to the emergency department. Advancements in remote monitoring and virtual care technology can also positively impact healthcare delivery with a reduction in patient stress by allowing patients to be treated from the comfort of their own homes while eliminating the need for in-person facility visits. This can lead to the reduction of clinician and nurse burnout by giving the clinicians the tools to deliver more targeted care and practice at the top of their license. Clinicians will then be able to give patients a more complete and accurate picture of their longitudinal health profile and how to maintain or improve their health levels. Wearables can also benefit patients as they give a more accurate and continuous view of their health and empower them to automatically record health data such as blood pressure and heart rate which are essential to monitor for the chronically ill, particularly seniors (who often may forget).
Lessons Learned:
Nurses need to be backed by strong training and technical support in order to enhance the impact of digital health solutions.
Despite the many benefits of digital health innovations in nursing practice, nurses have been reluctant to adopt technology because of inadequate support, complicated systems, and technological lapses.
Globally, there was a massive increase in nurse shortages and poor retention that only got worse during the COVID-19 pandemic because of the increased health risk and inadequate support.
As noted in one study “nurses provide about 80% of care and are described as a link between patients and processes.”
The top nursing challenges are nurse retention (61%), nurse recruitment (59%), nurse engagement (35%), and nurse leadership development (33%) per the 2017 Health Leaders Media Nursing Excellence Survey.
Lack of nurse leadership poses a major challenge to nurse engagement with digital technology.
Shifting care from the hospital to the home with digital technology can empower patients and clinicians.
Enhanced remote monitoring technology can positively impact healthcare delivery by 1) reducing patient stress and allowing patients to be treated from the comfort of their own homes; 2) limiting expensive and unnecessary visits, like ER visits; and 3) reducing clinician burnout, eliminating unnecessary testing and improving diagnosis by giving them a completer and more accurate picture of their patient's longitudinal health profile.
During the pandemic, the use of telehealth skyrocketed but not all organizations’ telehealth platforms have been effective. …Providers need to strategically evaluate both telehealth technologies and the specific demographic, and technological and physical capabilities of their patient population to ensure a fit between the two.
According to the Association of American Medical Colleges (AAMC), the physician shortage in the United States is anywhere from 40,800 to 104,900 physicians by 2030
A study conducted by Wheel found that clinician burnout impacts 80% of patients and 1 in 3 patients believe burnout impacts their quality of care
For example, during the so-called “Great Resignation,” where large numbers of working-age people have simply dropped out of the labor force, approximately half a million healthcare workers have quit since February 2020 according to a recent article in Forbes.
The stress of dealing with the continuous over two-plus year Pandemic has taken a great toll on clinicians' emotional, and physical health leading to burnout. For many, this has left them with two options–either to step away or go digital.
Leveraging virtual care is one way to deal with a number of the issues of healthcare workforce shortages that were exacerbated by the Pandemic.
Digitizing the supply chain can help reduce clinician burden by reducing the need to track down supplies.
Digitalization increases supply chain network visibility, enables strategic relationship planning, and uncovers opportunities for establishing new relationships.
According to the Institute for Supply Management (ISM), 59-83% of organizations reported an increase in lead times for acquiring supplies since the onset of the pandemic.
88% of healthcare executives identified AI as a critical technology for supply chains in the next three years.
Virtual care tools can help reduce the shortage of nurses.
Hospitals lost approximately 2.5% of their nursing workforce in 2022, resulting in the average hospital losing between $5.2M-$9.0M according to the NSI Solutions 2022 NSI National HealthCare Retention & RN Staffing Report
There is predicted to be a shortage of over 500,000 RNs by 2030 with the greatest shortages seen in the South and West, according to one 2018 study.
More than 1M registered nurses were predicted to leave the workforce by 2020 according to a 2017 article in Health Affairs, which was taken prior to the extreme stress and burnout of the Pandemic.
A number of studies have found that “nurses spend between 26%-41% of their time on documentation activities and that is a major source of what burdens them.” As a result, one study recommends deploying technologies like natural language processing (NLP) to capture and search clinical notes as well as AI-based tools such as predictive analytics, to help risk stratify patients.
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