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Should We Continue Wearing Fitness Trackers?

Posted on December 28, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Wired recently published an article that says “Science Says Fitness Trackers Don’t Work. Wear One Anyway.” No doubt they chose the headline to cue off of the word science in our political world. However, their article lacked substance as to why people should wear a fitness tracker even though we’ve already said with our actions that we’re not interested.

In fact Wired leads off with this in their article:

Our devices, apps, and platforms, experts increasingly warn, have been engineered to capture our attention and ingrain habits that are (it seems self evident) less than healthy.

Unless, that is, you’re talking about fitness trackers. For years, the problem with Fitbits, Garmins, Apple Watches, and their ilk has been that they aren’t addictive enough. About one third of people who buy fitness trackers stop using them within six months, and more than half eventually abandon them altogether.

The follow this up with 2 studies that show that fitness trackers are ineffective but go on to argue that fitness trackers are getting better and so we should keep wearing them.

Needless to say, I’m not convinced and I don’t believe the majority of the population will be convinced either. I’ve long argued that what we really need mobile health sensors to accomplish is for them to become clinically relevant. Once these sensors are clinically relevant, then we’ll all wear them much more. Until then, these fitness trackers and other health sensors will just be novelty items which we discard after a short period (except for the crazy few quantified selfers out there).

It’s really a simple math. As soon as the value of wearing a health sensor outweighs the cost of wearing one, we’ll all do it. I believe that the key to showing that value is to make the data the health sensor collects clinically relevant.

Lately, I’ve seen some patient advocates suggesting that EHR patient portals should really embrace patients uploading their sensor data to the portal. While I think the posture of empowering patients outside of the office is important, there’s very little value for doctors or patients to have them upload their current sensor data. What will change this? That’s right…once the data becomes clinically relevant, then every doctor will want that data to be uploaded. This demand will drive every EHR vendor to implement it. Problem solved. Until then, don’t hold your breath.

What do you think of fitness trackers? Should we keep wearing them? When will health sensors finally become clinically relevant?

The Future of Small Medical Practices

Posted on December 27, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the questions I get most often relates to the future of small practices in healthcare. I’ve heard a lot of people make really great arguments for why small medical practices have an extremely challenging future in healthcare. We’ve all heard stories of large healthcare organizations eating up small medical practices left and right.

For the longest time, I’ve argued that this is all just part of a cycle of doctors selling to hospitals and then doctors hating life as an employed doctor and so they return to running their own practice. This cycle seems to be playing out and most doctors still hate being employees. However, there are a lot of other forces at play that makes it harder for doctors to go out and start their own independent medical practice again.

As I look at the biggest healthcare trends, none of them point to a brighter future for the small, independent medical practice. In fact, most of them make it even harder for small medical practices to survive.

For example, the shift to value based reimbursement is something that should be a great thing for small medical practices that have been known to provide the highest quality, personalized care. While this is true, must of value based reimbursement is as much about understanding and applying the data to a population in order to improve the overall health. How many small practices are going to be capable to do this type of data analysis?

If you extrapolate this further, it’s hard to imagine a future healthcare system that’s not built on the back of data. If that’s the case, he who holds the data holds the power. It’s worth asking if even the hospitals and health systems will be large enough to have the data they need on their patients. Or will even the largest hospitals and health systems need to work with massive companies like Google and Amazon who are currently collecting data at rates that no hospital could even consider?

This is a scary and exciting future that is a topic for another post. However, from a small practice perspective, this could be a good thing. If large corporations like Google and Amazon have the data needed to improve healthcare, then it’s possible that those corporations will enable small practices to survive. It could level the playing field for small practices that are trying to compete with large health systems.

What’s certain is that every healthcare organization is going to have to move beyond just the EHR. Sure, the EHR will be a requirement for every medical practice, but I believe it will only be the start. For small and large medical practices to survive, they’re going to have to start exploring what other technology they can implement to provide a better patient experience. The good thing is that small practices can be nimble and implement new technology quickly and without as much bureaucracy. The hard part is that they have to do so with a smaller budget.

What do you think about the future of small medical practices? Will they survive? Should we be making efforts to make sure they survive?

EHRs Could Be Causing Patient Harm More Often Than Expected

Posted on December 26, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Why did the healthcare industry invest so heavily in EHRs in recent years?  Obviously, one major reason is the payoffs that became available under HITECH, but that’s not all.

Another important objective for spending heavily on EHRs and other HIT options was to protect patients from needless harm, including everything from clinical decision support to finding grand clinical patterns among patients with similar conditions.

Now, nobody’s saying that none of these benefits have been realized. But according to one researcher, we haven’t paid enough attention to the ways in which these technologies can actually cause harm as well. In fact, some researchers say that HIT-related mistakes are not as minimal or easily managed as some think.

So how do we get a grip on how often HIT tools and EHRs are a factor in patient care errors? One way is to examine the role HIT has played in malpractice claims, which, while not offering a comprehensive look at how such mistakes occur, certainly gives us a look at where some of the biggest have taken place.

For example, look at this data from the Journal of Patient Safety, which dug into more than 300,000 cases from an insurance database to see what role HIT played in such cases. Researchers found that less than 1% of the total malpractice claims involved HIT, more than 80% of that 1% involved problems of medium to intense severity.

The researchers found three major reasons for EHR-related suits:

  • 31% involved medication errors, such as the case when a baby died from a drug overdose that took place because a handwritten order was entered in the computer inaccurately
  • 28% involved diagnostic errors, as when critical ultrasound results ended up being routed to the wrong tab in the EHR — which in turn led to a year-long delay before a cancer patient was diagnosed
  • 31% of cases were related to complications of treatment related to HIT errors. For example, in one case a doctor was unable to access emergency department notes, and the lack of that knowledge prevented the doctor from saving the patient

Unfortunately, if you’re a physician group member working within a hospital — particularly as an on-call clinician with little say about how HIT system should work — your group may be vulnerable to lawsuits due to technologies it doesn’t control.

Still, it doesn’t hurt to learn about common errors that can arise due to EHR and HIT malfunctions. When it comes to delivering patient care, the fewer surprises the better.

Study Says Physicians Have Major Cybersecurity Problems

Posted on December 18, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

New research sponsored by the AMA and consulting firm Accenture has concluded that cyberattacks on medical practices are common – in fact, far more common than one might think.

Not only do these numbers suggest patient data is far more vulnerable than expected, it suggests that clinicians are often poorly educated about security and the implications of handling it badly. It’s fair to say that unless this trend is turned around, it could undermine industry efforts to build trusting relationships with patients and encourage them to engage in two-way data exchange.

The study found that most physicians (85%) think that sharing electronic protected health information is a good idea and that two-thirds believe that giving patients more access to their health data would improve care. One-third of respondents said that they share ePHI if they trust the vendors involved.

Thirty-seven percent get training content on security from their health IT vendor, and 50% said they trust these training providers are sure the content is adequate. However, this may be a mistake. While 87% of respondents said that their practice is HIPAA-compliant, the study also found that two-thirds of doctors still have basic questions about HIPAA. It’s clear, in other words, that trusted relationships aren’t doing the job here.

In fact, an eye-popping 83% of medical practices have experienced some form of cyberattack such as malware, phishing or viruses. Not surprisingly, 55% of physicians surveyed are very worried about future cyberattacks. Unfortunately, worrying is what many people do instead of taking action, and that may be what’s going on here.

What makes these lax attitudes all the more problematic is that when attacks occur, the effect can be very substantial. For example, 74% of respondents said that a cyberattack was likely to interrupt their clinical practice, and 29% of doctors working in medium-sized practices said that it could take up to a full day to recover from an attack, a crippling length of time for any small business.

So what are practices willing to do to avoid these problems? Among these respondents, 60% said they would pay someone to create a security framework to protect ePHI. Also, 49% of practices surveyed have in-house security staffers on board. However, it should be noted that three times more medium and large practices have such an officer in place compared to smaller medical groups, probably because security expertise is very pricey.

However, probably the most valuable thing they can do is the least expensive of the list. Every practice should require that physicians stay current at least on HIPAA and cybersecurity basics. If medical groups do this, at least they’ve established a baseline from which they can work on other security issues.

AI and Machine Learning Humor – Fun Friday

Posted on December 15, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Two of the biggest buzzwords right now in healthcare are AI and machine learning. The problem is that both of these things are real and are going to impact healthcare in really significant ways, but everyone is using them to apply to everything. Once the industry starts doing that, words lose their meaning.

That said, I still couldn’t help but laugh at this AI and machine learning cartoon (Credit to Andrew Richards for sharing this cartoon with me):

The sad reality is that this is what many companies are doing. They look for the answers they want instead of looking at what answers the data provides. That’s a hard concept for many to grasp and takes a real expert to do the latter effectively.

4 Reasons Patient Texting Is Taking Center Stage

Posted on December 14, 2017 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

Communication is one of the most time consuming tasks for medical practices. Hundreds of patients need to be contacted on a regular basis. Keeping up can be a challenge. Failing to do so can be damaging to the practice. Modern patients have adopted a consumer-based mentality and are quick to switch practices when it does not live up to their expectations. Communication methods that used to be regarded as personal and engaging are now felt to be invasive and outdated. The stats back it up:

  • Nineteen percent of people never check their voicemail.
  • Ninety percent of cell phone users ignore incoming phone calls.
  • Seventy eight percent of emails are never opened.

What do patients want instead? Texting.

The “Why” Behind the Success of Texting

Today’s patients are already savvy texters in their everyday lives and expect to be able to do the same with their medical practices. The Patient-Provider Relationship Study found that 79 percent of patients would like to receive text messages from their doctor and 73 percent want to send a text to their doctor’s office. In response, more and more offices are turning to texting. Why is texting so critical to practice success?

  1. It’s faster for everyone. The average text message takes just four seconds to send. Compare that to a phone call, in which people talk for at least two minutes. Those two minutes don’t include the time spent dialing, waiting for an answer, leaving a message, or following up. Experts estimate that a phone call to schedule an appointment—from start to finish—takes 8.1 minutes. Those minutes add up. For example, if your practice receives 50 incoming phone calls each day, even at just two minutes per call, that’s almost two hours spent on the phone. Add to that outbound calls and the hours build even more. Text messages, on the other hand, take only seconds to type and send.
  2. It improves health outcomes.research study by JAMA Internal Medicine reviewed data from 16 randomized clinical trials and found that texting can double the odds of chronic illness patients sticking to medication adherence. When using text messages as ways to remind patients of appointments and medication needs, they resoundingly respond.
  3. It keeps the schedule full. A text message system can be completely automated—meaning it can send notifications as often as desired. This ensures lower rates of patient no-shows. In addition, when a last-minute cancellation happens, texting is a great way to fill those spots. Patients who want to be seen soon can be put on a waiting list. When someone cancels their appointment, an automated text can be sent to each patient on the waiting list letting them know an appointment has become available. This text takes far less time than calling each person on the waiting list and hoping to reach an available patient in time to rebook the appointment. Your schedule stays full and your revenue increases.
  4. It increases in-office engagement. Freeing up so much time allows front office staff to spend more time where they are needed most—engaging in compassionate care with the patient right in front of them. Extensive research has found that patient-based, compassionate care leads to lower stress levels and burnout for healthcare providers and better health outcomes and satisfaction for patients. This type of care is only made possible, however, when staff members are not talking on the phone all day. Texting frees up this time.

Texting is the norm in almost every aspect of our society, and it is quickly becoming the expectation in the healthcare industry as well. It offers patients an easy way to communicate with your practice and still provide great service to the patients you are serving in your office. Your patients are happy with the way your practice communicates, you reduce the amount of time spent on phone calls, and—most importantly—your practice continues to grow.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff. Learn more about the Patient-Provider relationship survey here.

Coping With The Loss Of Your Ambulatory EMR

Posted on December 13, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Despite the struggles involved, most practices seem to have settled in with an EMR they can at least tolerate. Their workflows are, well, working, the practice management features seem to connect with the clinical ones and most clinicians are complaining about using it.

Yes, your practice may have had to go through a few systems before you found one everyone liked, wasn’t too expensive and had decent technical support to offer.  By this time, though you may have been a little scarred by the experience, hopefully practice leaders have gotten comfortable with the central role the EMR plays in the practice.

Then, you decide it makes sense to sell your practice to the local health system. It could be because it’s an irresistible deal financially, or you feel you can’t survive without their help and partnership, or any number of additional reasons. Everything looks good, but then you take a hit: your new “partner” wants to dump the EMR you worked so hard to find and customize. They want you to work on the same enterprise system they do.

Now, from a hospital’s perspective that may make sense. Here’s how one consulting firm lays things out:

“[When acquiring a medical practice] one critical issue is how to transition the workflow of these physicians and their staff from the practice-owned ambulatory EMR to the centralized hospital-owned EMR to ensure the efficient and safe delivery of care to patients,” it tells its hospital customers. In other words, it’s a question of when and how, not IF the hospital should require acquired practices to make the switch.

The thing is, while the hospital may have a comparatively large staff dedicated to integrating and managing the data pulled in from your ambulatory EMR, the reverse is probably not true. Unless your practice is particularly large, it probably only includes 5 to 10 doctors. In such practices, having even a single data expert on staff would be unusual. (Not to mention that hiring one part-time or as a consultant wouldn’t be cheap.)

In other words, for a while you may be fishing for your patients’ data as you transition to the larger team to which you will belong. Also, until the hospital health system completes integrating the data from your practice into its enterprise system, you may or may not have access to quality metrics important to running a practice these days, and the effect on your billing practices could turn out to be a disaster too.

At this point, I’m supposed to stop and tell you that all this can be handled efficiently if you take one step or the other. Unfortunately, I’m not sure there is any great happy ending to suggest at this point. If you have to give up your own ambulatory EMR, it’s probably going to be painful.

However, it doesn’t hurt to be prepared. There probably are some strategies, perhaps unique to your practice, that can blunt the impact of some of these problems if you’re prepared. That said, the move to a new EMR is always painful, even if the change ends up being a good one.

Alexa and Medical Practices

Posted on December 12, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today I was asked to do a webinar for Solutionreach on the topic of “What You Need to Know for 2018: From Government Regulations to New Technology.” It was a fun webinar to put together and I believe you can still register and get access to the recorded version of the webinar.

In my presentation, I covered a lot of ground including talking about the consumerization of healthcare and how our retail experiences are so different than our healthcare experiences. In 2018, I see the wave of technology that’s available to make a medical practice’s patient experience be much closer to a patient’s retail experience. That’s exciting.

One of the areas I mentioned is the move to voice-powered devices like Amazon Echo, Google Home, Siri, etc. Someone asked a question about how quickly these devices were going to hit healthcare. No doubt they have experienced how amazing these devices are in their home (I have 2 at home and love them), but the idea of connecting with your doctor through Alexa is a little mind bending. It goes against our normal rational thoughts. However, it will absolutely happen.

Just to be clear, Alexa is not currently HIPAA compliant. However, many things we want to do in healthcare don’t require PHI. Plus, if the patient agrees to do it, then HIPAA is not an issue. It’s not very hard to see how patients could ask “Alexa, when is my next appointment?” or even “Alexa, please schedule an appointment with my OB/GYN on Friday in the afternoon.” The technology is almost there to do this. Especially if you tie this in to one of the patient self scheduling tools. Pretty amazing to consider, no?

I also highlighted how the latest Amazon Echo Show includes a video screen as well. It’s easy to see how one could say, “Alexa, please connect me with my doctor.” Then, Alexa could connect you with a doctor for a telemedicine visit all through the Alexa Show. Ideally, this would be your primary care doctor, but most patients will be ok with a doctor of any sort in order to make the experience easy and convenient for them.

Of course, we see a lot of other healthcare applications of Alexa. It can help with loneliness. It can help with Alzheimers patients who are asking the same question over and over again and driving their caregiver crazy. It could remind you of medications and track how well you’re doing at taking them or other care plan tracking. And we’re just getting started.

It’s an exciting time to be in healthcare and it won’t be long until voice activated devices like Alexa are connecting us to our healthcare and improving our health.

What do you think of Alexa and other related solutions? Where do you see it having success in healthcare? How long will it take for us to get there?

Note: Solutionreach is a Healthcare Scene sponsor.

MIPS Twitter Roundup – MACRA Monday

Posted on December 11, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

As we near the end of 2017, I found a number of tweets from CMS and other people that I thought would be useful to those that are interested in MACRA and MIPS.

First up is this tweet from CMS that it’s not too late to still participate in MIPS and collect some performance data before the end of 2017. This is them promoting the Test Option which would allow you to avoid the 4% penalty:

Next up is a fact sheet from CMS which outlines the different between 2017 and 2018 when it comes to MACRA/MIPS. I particularly like page 6 of the document. As you go through it, you’ll realize why 2018 is going to be much harder than 2017.

Next up is a stat from MGMA. I’d be interested in learning about the 14% of practices that think that their value-based reimbursement is going to decrease. Are these people going to direct primary care? I don’t see it going down for almost anyone. What do you think?

Finally, Matt Fisher asks a question about whether MIPS should be voluntary. I don’t think they can make it any more voluntary given the current legislation and do any of us think that congress is going to take up this topic? I don’t. So, it’s kind of a moot point. However, there is a lot of doctor angst about MIPS/MACRA. I just don’t see enough of it to really move the needle on things. I think we’re stuck with MACRA/MIPS for the forseeable future.

Burnout is Overused and Under Defined

Posted on December 8, 2017 I Written By

When Carl Bergman isn't rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of EHRSelector.com.For the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manager doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst, a role he recently repeated for a Council member.

Recently, John hosted a #HITsm chat on using technology to fight physician burnout (Read the full transcript from the chat here). The topic’s certainly timely, and it got me to wondering just what is physician burnout. Now, the simple answer is fatigue. However, when I started to look around for studies and insights, I realized that burnout is neither easily defined nor understood.

The Mayo Clinic, among others, defines it this way:

Job burnout is a special type of job stress — a state of physical, emotional or mental exhaustion combined with doubts about your competence and the value of your work. 

So, it is fatigue plus self doubt. Well, that’s for starters. Burnout has its own literature niche and psychologists have taken several different cracks at a more definitive definition without any consensus other than it’s a form of depression, which doesn’t have to be work related.

Unsurprisingly, burnout is not in the DSM-5. It’s this lack of a clinical definition, which makes it easy to use burnout like catsup to cover a host of issues. I think this is exactly why we have so many references to physician or EHR burnout. You can use burnout to cover whatever you want.

It’s easy to find articles citing EHRs and burnout. For example, a year ago April, The Hospitalist headlined, “Research Shows Link Between EHR and Physician Burnout.” The article then flatly says, “The EHR has been identified as a major contributor to physician burnout.” However, it never cites a study to back this up.

If you track back through its references, you’ll wind up at a 2013 AMA study, “Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy.” Developed by the Rand Corporation, it’s an extensive study of physician job satisfaction. Unfortunately, for those who cite it for EHR and burnout, it never links the two. In fact, the article never discusses the two together.

Not surprisingly, burnout has found its way into marketing. For example, DataMatrix says:

Physician burnout can be described as a public health crisis especially with the substantial increase over the last couple of years. The consequences are significant and affect the healthcare system by affecting the quality of care, health care costs and patient safety.

Their solution, of course, is to buy their transcription services.

What’s happened here is that physician work life dissatisfaction has been smushed together with burnout, which does a disservice to both. For example, Medscape recently published a study on burnout, which asked physicians about their experience. Interestingly, the choices it gave, such as low income, too many difficult patients – difficult being undefined — are all over the place.

That’s not to say that all physician burnout studies are useless. A recent study, Electronic Health Record Effects on Work-Life Balance and Burnout Within the I3 Population Collaborative, used a simple, five item scale to ask physicians how they viewed their work life. See Figure 1.

Figure 1 Single-Item Burnout Scale.

Their findings were far more nuanced than many others. EHRs played a role, but so did long hours. They found:

EHR proficiency training has been associated with improved job satisfaction and work-life balance.14 While increasing EHR proficiency may help, there are many potential reasons for physicians to spend after-hours on the EHR, including time management issues, inadequate clinic staffing, patient complexity, lack of scribes, challenges in mastering automatic dictation systems, cosigning resident notes, messaging, and preparing records for the next day. All of these issues and their impact on burnout and work-life balance are potential areas for future research.

There’s a need to back off the burnout rhetoric. Burnout’s overused and under defined. It’s a label for what may be any number of underlying issues. Subsuming these into one general, glitzy term, which lacks clinical definition trivializes serious problems. The next time you see something defined as physician or EHR burnout, you might just ask yourself, what is that again?