IT leaders talk about EHRs as a factor to reduce burnout for physicians, other clinicians

It does not take a massive investment of time and money to chip away at the total time that physicians and other clinicians spend doing administrative tasks in electronic health records (EHRs), health system information technology (IT) leaders said.

The Virginia Hospital & Healthcare Association’s Center for Healthcare Excellence recently convened the Virginia Patient Safety Summit, a daylong webinar with the theme “Safe Care, Every Step of the Way: Advancing a Culture of Safety in Healthcare.”

That culture includes optimizing work conditions to help physicians and other clinicians treat their patients. In recent years, Virginia health systems have become leaders in making operational changes that reduce administrative burdens, including the minutes that add up to hours spent clicking through computer prompts. Health networks there have earned recognition by the Dr. Lorna Breen Heroes’ Foundation, a leader in the ALL IN: Caring for Caregivers campaign to improve health workers’ well-being and mental health.

That initiative has the following three parts, said the foundation’s chief medical officer, Stefanie Simmons, M.D., at the webinar:

• Reducing barriers to seeking mental health treatment by reforming licensing and credentialing applications.
• Assisting health care leaders in understanding a systems approach to clinician well-being.
• Integrating well-being into operational improvements.

The third component, so far, has involved partnerships with seven health systems to accelerate quality improvement projects that reduce administrative burdens, a leading cause of burnout among physicians and other clinicians. Simmons introduced three health tech leaders to explain their projects.

Getting help for responses

As EHRs have become more available to patients, physicians and other clinicians get more messages from patients requesting advice, said Lindsey Stanton, DNP, an associate chief health informatics officer, ambulatory, at Inova Health System in Fairfax, Virginia. The leadership team aimed to find a solution to reduce the time and effort required to address those queries.

They used the program Art, by Epic, an artificial intelligence (AI) tool that analyzes patient messages and drafts the opening of a clinician response.

“It would never replace your clinical judgment or what you know to be the right answer as the person on the health care team, but it gives you a starting point that you can edit, [to] save some time and get through your tasks a little bit more quickly,” Stanton said.

A pilot program started in May 2024 with a small group of clinicians. The health system scaled it to 110 users by April 2025 and, in November, adopted an advanced categorization model, enabling more in-depth responses and the ability to respond to messages with multiple topics, Stanton said.

She offered examples of user comments asking for access to the program and suggesting an expansion plan for it. One user commented that Art’s tone was nicer than their own.

The program was used for all clinicians: Physician assistants and nurse practitioners had the highest usage rates, followed by physicians, registered nurses, midwives, medical assistants (MAs) and licensed practical nurses. A 12% utilization rate may seem low, but not every patient request needs a custom response, so the result was fairly good, and the positive feedback on the utilization rate was 65%.

The program saved 28 seconds per message for the pilot group compared with clinicians who did not use it. That tallied up to 22 hours saved from May to August 2025 with the pilot group, and the advanced version of the program helped save 40 seconds per message.

“Our big recommendation here is that all [people in] roles who can benefit should be included,” Stanton said. “There are discussions with this tool about, you know, should nursing and support staff and MAs be able to access it, or should it really just be for providers? And if you set it up in a way that's safe and useful for those clinicians, I would definitely say we learned that it's impactful for those team members as well, and they field a lot of these kinds of messages. So, bringing this burden reduction to all of the members of the care team was a big takeaway for us.”

Saving time through presets

When looking for improvements, especially in technology, it’s easy for health care leaders to fall prey to shiny object syndrome — the desire for the newest EHR feature. AI is like that, especially for computer and tech enthusiasts, said Richard Truxillo, D.O., associate chief medical information officer at Carilion Clinic of Roanoke, Virginia.

It’s also possible to find simpler solutions in existing programs. Carilion Health staff started with the Epic preference list, a built-in list of preferred medications with preselected default settings. It’s meant to promote consistency and safety while lowering risk of errors, cognitive load and mouse-and-click burdens, Truxillo said.

Carilion Health formed a physician builder team, comprising doctors certified by Epic, to become builders in its EHR.

“What's great about the physician builder team is [that] we can improve clinical workflow efficiency, because we're not just builders, we're also users of the system,” Truxillo said. “We're able to talk to our colleagues, see what works, what doesn't work, and with that, you get more buy-in and ownership and adoption and alignment between the technology partners, patient care providers, and the system as a whole.”

Examining the order rates for 200 medicines, the team reduced the time spent per order so much that it annualized to approximately 103 hours saved, or the equivalent of 2.5 work weeks for physicians and other clinicians to engage in patient care.

“I want you to challenge yourselves to find opportunities to optimize what you already have in place in your EHR,” whether in Epic or another program, or with the work templates, order sets and preferences, Truxillo said.

Alerts, alerts and more alerts

Many hospitals or health systems may have alarm fatigue committees, groups that meet once or twice a year to examine every chime and ding that make up the background noise in a hospital. Overexposure to audible cues causes alarm fatigue, desensitization that makes workers less likely to heed them, and increased burnout, said Jenna Dziuba, M.S.N., RN, NI-BC, corporate director for health informatics and chief health informatics officer at Centra Health of Lynchburg, Virginia.

A large proportion of health system leaders don’t give the same level of consideration to EHR alerts, Dziuba said. At Centra Health, the team looked at a month’s worth of alerts in 2024, and the numbers added up, as follows:

• 88,758 alerts for the “sticky note” function that went live with the EHR system. As workflows improved, most people weren’t using it anymore, so silencing it would cut almost 90,000 clicks a month.
• 74,025 alerts for first-dose education for new medicines. Nurses wanted to educate their patients about their medications, but the alert was not specific and disrupted workflow. Moving it in the workflow created a better reminder for patient education.
• 51,075 alerts for medicine reconciliation. It is another important step in treatment, but turning it off for nursing and relocating it in the workflow made it more effective for physicians and other clinicians.

The system added guidelines for new alert requests, Dziuba said.

“These don't go so far as to say you can never do an alert, because they do serve important purposes and are necessary, but it just helps to define better what makes a good alert and recommends thinking about different areas in the workflow through workflow analysis, making alerts that are measurable, that we can check to see that the desired outcome is happening.”

The presentations show that “subtraction, in and of itself, can be innovative,” Dziuba said.

“You can take small bites, meaningful pain points can be addressed a little at a time, and you can set up ongoing work with this,” she said.

Additional summit sponsors included the Virginia Nurses Association/Virginia Nurses Foundation, the Medical Society of Virginia, the Virginia Pharmacy Association and the Virginia Society of Health-System Pharmacists.