Combating healthcare staff shortages with digital solutions

Okan Ekinci, MD, MBA

SVP, Global Head of Marketing & Innovation, Roche Information Solutions

Combating healthcare staff shortages with digital solutions

23 January 2023 | 10min

Quick Takes

  • Healthcare systems worldwide are facing severe staff shortages that can result in significant implications, especially for patients

  • Digital health solutions can help alleviate staff shortages by taking on administrative and low value tasks, and supporting more efficient workflows

  • For successful adoption and use of digital health solutions, healthcare institutions need the right set of partners to help manage the technology shift

Staff shortages in healthcare: Crisis or opportunity?

Healthcare systems across the world are facing severe staff shortages, a phenomenon that The Guardian just recently described as “a ticking time bomb”.1 The latest Becker’s Physician Leadership survey shows that healthcare executives cite staff shortages as their number-one concern facing healthcare systems.2 The World Health Organization (2022) estimates that there will be a worldwide shortage of 15 million healthcare workers by the year 2030.3 In the US alone, 100,000 nurses left the workforce between 2020 and 2021, many of whom are below the age of 35.4

The staff shortage in healthcare has many root causes. One is the demographic effect caused by the large numbers of the baby boomer generation retiring. Others are medically related, for example, the rise in non-communicable diseases, and the ongoing COVID-19 pandemic.  All these factors have contributed to an increased need for care and there is simply not enough supply to meet the demand. Simultaneously, younger professionals are leaving the healthcare sector due to burnout and low job satisfaction.

Healthcare staff shortages have significant implications for everyone in the healthcare ecosystem, including patients. Because there are not enough workers to carry out basic and necessary tasks, the remaining healthcare workers face heavier workloads, with many tasks oftentimes falling outside of what they are trained to do and want to do. In the US, doctors are estimated to spend a sixth of their time on administrative tasks.5 This contributes to higher levels of burnout and lower job satisfaction, which in turn, leads to more staff quitting, thus perpetuating a vicious cycle of staff shortages.5,6  

How does this affect patients? The first obvious impact is longer wait times caused by inefficient workflows. According to Dr. Richard Hammer, vice-chair of pathology at the University of Missouri, patients are often unable to get phone calls answered. When their calls are answered, they might be told that there are no appointments available for at least three months, which for many people and illnesses, is too long to wait.

Staff shortages also place a financial burden on healthcare systems. With such a short supply of healthcare workers, systems have to spend more to acquire and retain talent. That said, if there are not enough personnel with the right skills and expertise to perform the job, even ample financial resources cannot fix the issue.

If the staff shortage issue is not addressed, our healthcare systems’ long-term sustainability and productivity to deliver better patient care will be at risk. This is not an easy challenge to fix, and innovative solutions will be critical for filling the void caused by staff shortages.

Digital health solutions can help alleviate staff shortages

Digital health solutions across different areas of the care continuum have been shown to alleviate healthcare staff from administrative, low-value tasks, and support more efficient workflows.7,8 Faced with the rising challenge to find the right staff – healthcare leaders should investigate how digital health solutions can help retain and support staff and bring smarter, more efficient workflows to their organization.

Digital solutions help efficiently manage data, devices, and personnel at the point of care

Nurses and care coordinators are among the most scarce medical workers.9 Yet, today, they are asked to manually perform and manage tasks that digital solutions could help support. In point of care, there are three main challenges when it comes to healthcare delivery: 

  1. Managing data that is collected across many locations inside and outside the hospital setting, and then transferring this data safely and securely to a patient’s electronic medical record (EMR)
  2. Managing the diagnostic and monitoring devices used across the hospital ward, ambulatory care centers, or emergency rooms 
  3. Managing personnel, ensuring that people are trained and up to date to perform the diagnostic tests on patients

3 challenges in point of care testing that digital health solutions may help to solve are the management of data, devices and personnel.

When it comes to managing data, most nurses carry a laptop with them to the patient’s bedside to enter the data into the electronic medical record (EMR) or they write the data on a post-it note and enter it into the patient’s EMR later. Both of these methods are associated with unnecessary administrative burdens (manual data entry) and also a high error rate. Here is where digital solutions can help. What if a nurse could directly transmit data from the device to the EMR without the need for any manual data transfers? 

In the case of managing devices, a large hospital system might have 1000 to 1500 handheld diagnostic devices like a glucometer – not to mention other devices – floating around a facility or several facilities. Having this many devices makes it difficult to manage software updates, which then leads to devices being outdated. Not only is this associated with obvious security risks, but in these situations, nurses may have to get a device from a different floor or location because the device available on their floor might not be working properly. This also takes precious time away from the nurse for patient interaction and care. Imagine if devices could simply receive updates remotely – in a secure way on a timely basis with little interaction from every nurse.

Finally, in point of care testing, managing personnel is always a major challenge. The reason being that only trained personnel can perform tests, but many current systems make it difficult to keep track of each nurse’s certifications.

Already today, there are digital point of care solutions that simplify many low-value, repetitive tasks such as data transfer, software updates, and personnel certification management.10 Our cloud-based solutions allow data to be transferred seamlessly from the device to the EMR. These solutions allow for the decentralized management of testing while freeing up the time of nursing personnel, which, in fact, leads to more time for patient-centric care.

According to Matt Manley, Vice President of Digital Healthcare Solutions at Roche Diagnostics, the examples above illustrate how “not using digital solutions places a greater administrative burden on a critical resource that’s already understaffed and overburdened. The automation that digital solutions enable relieves healthcare staff burden and frees up time for them to do what they do best – namely care for patients.”

Many exciting innovations lie on the horizon for point-of-care testing, including the first next-generation smart-device glucometer, which runs on an easy-to-use Android-based platform, broadening the use of the device beyond glucose measurement to services such as wound management, insulin dosing, and continuous temperature management amongst others.11 These devices can further support nurses, simplifying their workflows and potentially relieving some of the time and task pressure they are facing in the current system. 

Decentralized care is patient-centric care. Yet this creates complexity for the healthcare system. Digital solutions for point of care are essential for managing this complexity and maximizing the impact and efficiency of delivering decentralized care

Matt Manley

How digital solutions improved operational efficiencies for a leading cancer care center

Digital solutions have made a huge difference in oncology. Oncology care is complex and most recent scientific advances allow for more personalized treatments than ever before. These advancements however also create complexities, leading to many specialties being involved in defining treatment paths for individual patients. 

Ellis Fischel Cancer Center at the University of Missouri is one of the leading academic centers in the United States where oncology treatment decisions are taken in 12 subspecialty tumor boards. In 2018, a team around Dr. Richard Hammer pioneered the implementation of a digital solution supporting the decision-making and decision documentation within tumor boards. 

Prior to the implementation of digital solutions, tumor boards took a long time (an average of six hours just to prepare). Participating parties used PowerPoint slides or large stacks of papers, and coordination among the various parties involved was inefficient.

Dr. Richard Hammer

 

The University of Missouri rethought how they ran tumor boards and implemented a digital health solution to support them.12 The results were dramatic. Administrative functions that were previously handled by twelve different people were handled by just one person – a nurse navigator. With the use of the digital health solution, the preparation time of the nurse navigator decreased by 90 percent, and overall staff preparation time reduced by 50 percent. The institution saved $USD 300,000 across four tumor boards.7,8

Beyond driving operational efficiencies, the team saw further unexpected benefits from implementing a digital solution into their oncology workflows. When the COVID-19 pandemic hit and doctors were no longer allowed to be in the same room at the same time, the University of Missouri was already ahead of the game with so much digital experience under their belt. Because the digital solution for tumor boards is browser-based, doctors could dial in remotely. According to Dr. Richard Hammer, doctors at the University of Missouri do not want to go back to the way things were before the pandemic. Having the flexibility to work from home has improved their job satisfaction.

I would endorse more technology rather than less as ways to overcome some of the staff shortages. There are still some silly things that are being done, like faxing. People still fax paper. Why would you do that? And you have to walk over to the fax machine and get it when it can just show up on your computer. So there’s a lot of technology that can be implemented. Some of it is not so hard. It’s really about change management and embedding these digital solutions into the day-to-day workflows of the hospital

Dr. Richard Hammer

Successful implementation of digital health solutions requires change management

To successfully implement digital health solutions, it is essential to team up with partners who understand the complexities of healthcare and bring that understanding to technology. Digital health providers should take the time to thoroughly understand the current workflows of their customers and provide digital health solutions that solve their needs. One of the greatest challenges in technology adoption is helping people adapt to the new way of working. Change management is just as important as technical implementation. 

When a new technology comes into the picture in any setting, some staff are early adopters of its use, while others are late adopters or even non-adopters. Some staff may be unfamiliar and uncomfortable with how to use new technology and others are not so keen to learn new ways of working. IT staff can play a significant role in helping staff adopt new technology, but IT workers are also understaffed in healthcare institutions and also not necessarily prepared to train other staff on new ways of working.

This is why it is vital to have a team specifically dedicated to change management. This team will be able to support the staff to meaningfully adopt and use digital health solutions. Digital transformation, ultimately, is people transformation. Successful institutions embrace that digital transformation requires an open mindset toward continuous improvement – in cycles. Teams who can quickly change and optimize clinical workflows, roles and responsibilities to adopt new digital tools display a skill I call “clinical agility”. They turn change into an opportunity through collaboration, empowerment, responsiveness, and quick decision-making. Over the long term, these teams become more resilient.13

The future of digital health solutions 

Staff shortages in healthcare are not just an inconvenience. Today’s current situation constitutes a crisis with major implications for all parties involved and most especially for the delivery of patient care. The issue is not going away, and healthcare organizations should approach the use of technology with an open mindset – and accept the idea that using more technology, not less, will actually help to curb and reverse this issue of staff shortages. 

Digital health solutions can help manage complexity, reduce administrative costs, streamline workflows, and overall alleviate some of the issues brought about by staff shortages. These solutions serve to make things easier for all parties involved, from healthcare administrators, and professionals, all the way to patients and their care. That is why implementing digital solutions is in the best interest of everyone. 

This shift towards adopting more technology represents an opportunity for healthcare leaders and their institutions to collaborate with the right set of partners to manage the adoption and use of digital health solutions for better patient care, and improved satisfaction of healthcare professionals while reducing costs. This would enable staff members to focus more on their main purpose and task, that of providing and delivering the best possible care for patients.

Okan Ekinci, MD, MBA is Head of Marketing & Innovation for Roche Information Solutions (RIS), where he focuses on delivering data-driven solutions that empower healthcare professionals and patients to make insights-based decisions. Okan has held multiple leadership positions in medical affairs and healthcare IT and spent eight of his 20+ years of experience in the healthcare sector in clinical practice in cardiology. Okan holds an MBA from the European School of Management and Technology, Berlin, an MD from the University of Mainz, Germany, and is adjunct professor of medicine at the University College Dublin, Ireland.

References

  1. Henley, Connolly, Jones and Giuffrida. (2022). Article available from  https://www.theguardian.com/society/2022/dec/14/a-ticking-time-bomb-healthcare-under-threat-across-western-europe [Accessed January 2023]
  2. Newitt. (2022). Report available from https://www.beckersphysicianleadership.com/news/survey-of-physicians-reveals-staff-shortages-by-practice-type.html?utm_campaign=physician&utm_source=website&utm_content=latestarticles [Accessed January 2023]
  3. World Health Organization. (2021). Report available from  https://www.who.int/health-topics/health-workforce#tab=tab_1 [Accessed January 2023]
  4. American Association of Colleges of Nursing. (2022). Article available from https://www.aacnnursing.org/news-information/fact-sheets/nursing-shortage  [Accessed January 2023]
  5. Woolhandler and Himmelstein. (2014). Int J Health Serv 44, 635-42.
  6. Medical Economics. (2021). Article available from https://www.medicaleconomics.com/view/top-challenges-2021-1-administrative-burdens-and-paperwork [Accessed January 2023]
  7. Roche. (2022). Webinar available from https://www.youtube.com/watch?v=wl9rjtRJC4s [Accessed January 2023]
  8. Hammer et al. (2021). Health and Technology 11, 525-533
  9. Bombardieri and Zhavoronkova. (2022). Article available from https://edition.cnn.com/2022/07/20/opinions/nursing-shortage-covid-hospitals-bombardieri-zhavoronkova/index.html [Accessed January 2023]
  10. Roche. (2022). Website available from https://diagnostics.roche.com/global/en/products/instruments/cobas-infinity-poc-ins-6818.html [Accessed January 2023]
  11. Roche. (2022). Website available from https://diagnostics.roche.com/global/en/products/instruments/cobas-pulse-system.html [Accessed January 2023]
  12. Roche. (2022) Website available from https://www.navify.com/products/navify-tumor-board/ [Accessed January 2023]
  13. Berlin, De Smet and Sodini. (2017). Article available from https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/why-agility-is-imperative-for-healthcare-organizations [Accessed January 2023]

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