With staffs shrinking and workloads growing for many health information (HI) teams, it’s no surprise that more HI professionals are feeling burned out, says Jami Woebkenberg, MHIM, RHIA, CPHI, FAHIMA, senior director for HIMS operations at Banner Health in Phoenix, AZ.
The problem seems to have worsened in recent years, particularly during the COVID-19 pandemic when more teams were stretched and illnesses took their toll on staffing, she says.
“Across the board, we expect more and more out of our employees,” she says. “We’re asking people to do more work. We’re asking them to do it more efficiently, and I think they feel that stress mentally and emotionally, and sometimes physically as well. It doesn’t matter what level you’re at, if we’re asking them to work 60 hours every week, certainly burnout is going to occur at some point.”
Burnout is widespread across the HI profession, according to a survey by NORC and AHIMA. The problem appears to impact most organizations that employ HI professionals, but was reported at higher rates among groups experiencing HI understaffing, according to the more than 2,500 HI professionals who responded to the survey. Seventy-six percent of those who reported understaffing said the shortages resulted in employee burnout and dissatisfaction.
Burnout is also the second most impactful driver for turnover, the survey found. Respondents working in revenue cycle vendor settings were more likely to report burnout as the top driver of turnover (41 percent), compared with respondents in hospital settings (27 percent), and non-hospital provider settings (28 percent).
The combination of high-pressure work, tight deadlines, and numerous demands from various sectors frequently create a recipe for burnout, says Susan W. Carey, MHIM, RHIT, FAHIMA, system vice president of IT patient services and HIM for Norton Healthcare in Louisville, KY.
“Every stakeholder that comes to health information management, basically has an issue that needs to be solved,” she says. “You’ve got attorneys chomping at the bit, regulations you have to follow, rules that say you’ve got to keep certain information protected, patients upset because they want their records. There can be a lot of stress.”
Although HI professionals are at the center of such complexity, their value and the importance of their work can go underrecognized, adds Susan Clark, BS, RHIT, CHTS-IM, CHTS-PW, senior director of program development for DirectTrust, based in Washington, DC.
“It’s evident that people will leave or seek other avenues if they are miserable,” she says.
Drivers of Burnout Among HI Professionals
The COVID-19 pandemic exacerbated employee burnout and dissatisfaction; the survey found. Of respondents, 59 percent felt the pandemic worsened staff workload for HI teams and individuals. Nearly half (49 percent) of respondents also felt COVID-19 heightened competition with other organizations for talent, which may have worsened understaffing and turnover issues.
“We definitely asked more of people during COVID,” Woebkenberg says. “Sometimes it’s those unplanned vacancies [where] somebody comes down with COVID or another illness and they’re off for significant time. It can certainly have an impact on your current staff. That can end up starting to cause burnout over time.”
Pressing governmental regulations is another contributor, the workforce survey found. One HI manager reported that staff at her small health system was burned out due to “increasing government rules and regulations, decreased revenue, increasing insurance denials, and frustration about the amount of time needed to document their work in order for the organization to get paid.”
External factors, such as omnipresent technology, can compound feelings of burnout, says Deb Boppre, MSM, RHIA, CCS, CCS-P, FAHIMA, enterprise health information/clinical documentation director for Trinity Health in Minot, ND.
With phones always at our fingertips, computers at home, and electronic messages constantly coming in, it can be difficult to separate work from home life, she says.
“The speed of technology, and all the technology that we have, that we never put down, contributes to burnout,” she says. “When people have the ability to work at any time, we gravitate toward that, but it’s not healthy.”
Source: Health Information Workforce: Survey Results on Workforce Challenges and the Role of Emerging Technologies. NORC and AHIMA. 2023
On a positive note, there seems to be more societal awareness about the importance of being emotionally and mentally healthy, Woebkenberg notes. Work-life balance is a frequent subject of studies, and literature about wellness and mental health are prevalent. In a 2022 analysis for example, findings showed a lack of work–life balance significantly increases burnout, which contributes to higher turnover intentions and lower career satisfaction.
More people are speaking out about their feelings and changing course if they’re feeling dissatisfied as well.
“People are looking at that more than in the past, and they’re realizing that they have a say,” Boppre says.
Easing Burnout, Boosting Wellness
At Banner Health, teams have incorporated a wellness program to help relieve stress among employees and promote emotional and physical health. The program includes virtual yoga classes, dance classes, and financial workshops, among other offerings, Woebkenberg says.
“A couple of weeks ago, they had this Zumba dance class. It was so much fun,” she says. “It was a nice break in the day. You forgot about work during that time. It was a good stress reliever.”
Leaders at Trinity Health have also developed initiatives to boost employees’ wellness, including a virtual bingo, Boppre says. During the game, employees receive a virtual bingo card and numbers are called throughout the week. At the end, winners receive a prize.
The game encourages teams to take breaks and improves connection between remote and on-site employees, she says. Staff also receive a regular themed newsletter with employee pictures, stories, and upcoming events.
“I think it helps everyone’s state of mind and prevents burnout because you reenergize and feel better,” Boppre says. “Employees love it. They always look forward to what we’ll come up with next.”
Allowing flexibility and remote schedules, when possible, also can help alleviate burnout, Clark says. Finding ways to incorporate functional artificial intelligence (AI) is another potential remedy. Whether it’s optimizing current AI tools, or investing in new tools, automating tasks can reduce stress on staff, she says.
Nearly half of respondents in the workforce survey (45 percent) reported that their organization uses AI or machine learning (ML) tools for coding, documentation, or other HI-related workflows. Use of AI and ML was higher in urban (50 percent) and suburban (51 percent) settings, compared with rural settings (28 percent).
Respondents said that certain AI/ML technologies eased staff burnout and overwork, including autonomous coding (48 percent), administrative workflow assistance (46 percent), chatbots (32 percent), and healthcare utilization management (30 percent). In addition, respondents reported improved productivity as a top benefit of AI and ML tools.
However, such tools may require increased oversight such as increased quality assurance and regulatory reporting burden, and that could lead to greater technical burden, survey respondents said.
Investing in organizational and functional process redesign, such as Lean Six Sigma, is another solution organizations should consider, Clark adds. Lean Six Sigma is a project management methodology that focuses on creating more value, reducing costs, and increasing productivity.
Teams are often so busy, they neglect to step back and take a holistic view of how work is being completed, end-to-end, she says.
“People are always wanting to improve, but it ends up being a patchwork of workarounds,” she says. “Organizations may be hesitant to invest in process redesigns because it can be a time and money thing, but you get the reward at the end by reducing burden.”
Alicia Gallegos is a freelance healthcare reporter based in the Midwest.
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