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HRM Task Force Recommendations

We heard you, and we're here to help   

Burnout is real. Administrative burden is the excess time and effort spent on clerical tasks and is linked to chronic stress, resulting in physician burnout and career dissatisfaction. Family doctors spend 19 hours a week [1] on administrative tasks, and 94% of those surveyed [2] said they were overwhelmed by these tasks. Reducing administrative burden is essential to help clinicians focus on patient care. In turn, these improvements will improve clinician satisfaction, reduce clinician burnout, increase time spent on patient care, increase patient safety and ultimately support an overwhelmed healthcare system.

"I spend countless hours clicking and scrolling through my EMR inbox, which is inundated with duplicate reports, long reports with repetitive information, and reports of tests I didn't order or know why a specialist ordered them. Late into the evening and on weekends, I click and scroll, anxious that I will miss an important abnormal lab or imaging test as these are unlabeled and unflagged – just buried in 100 to 200 messages. This uncontrollable, unlabeled and unflagged flow of patient data is a safety risk to patient care and a cause of burnout for our dwindling family physician workforce."  

Dr. Jocelyn Charles, Family Physician, Toronto

What we did 

OntarioMD established the HRM Experience Improvement Task Force ("HRM Task Force") to examine these issues and find solutions. The Task Force consulted a broad array of stakeholders in an effort to develop recommendations to reduce the administrative burden and get more time back for patient care. 

Health Report Manager (HRM®) Task Force Reports 

Hospital Findings and Recommendations 

The hospital findings and recommendations report focuses on hospital standards to address report delivery concerns. It includes detailed examples of issues clinicians are experiencing, provides the findings from the root cause analysis, and shares best practices and usability recommendations for hospitals to reduce clinicians' administrative burden, improve patient care and create capacity for clinicians, as well as short-term and long-term activities for implementing the recommendations.

The following issues are attributed to the upstream contribution of reports to HRM, primarily from hospital settings.

  • High Volume of Reports: Clinicians receive a high volume of reports, which can lead to information overload and potential risks to patient safety.
  • Duplication of Reports: Reports are sometimes duplicated, causing additional work for clinicians and increasing the risk of missing crucial information.
  • PDF Report Limitations: PDF reports limit the EMR's search capabilities, affecting data quality and patient-related quality improvement efforts.
  • Categorization of Reports: Inconsistent labelling/categorization of reports makes it challenging to identify relevant information quickly.
  • Lengthy Reports: Lengthy reports with inconsistent formatting can contribute to clinician burnout and increase the risk of missing critical patient health information.
  • Location-Based Report Delivery: Clinicians receive reports for all patients at every location rather than reports only for patients at each specific location. 

Review the recommendations in the Sending Facility Standards report (pdf) 

EMR Findings and Recommendations 

The EMR findings and recommendations report focuses on vendor-agnostic HRM usability themes. It contains recommendations for EMR vendors to adopt to optimize clinicians' workflows and improve the clinician experience with HRM. It outlines the short-term and long-term activities for implementing the recommendations. 

The following issues are attributed to downstream EMR usability concerns:

  • PDF Reports Searchability: Users face difficulties searching within PDF attachments.
  • PDF Reports Workflow: Opening PDF attachments requires additional steps and external applications.
  • Autocategorization of HRM Reports: Default autocategorization fields lack specificity, leading to manual adjustments.
  • Inconsistency of HRM Report Service Date vs. Received Date: Differences between these dates cause confusion.
  • Searchability - Lack of Inbox Filters: The lack of filters hampers efficient report prioritization.
  • Duplication of Reports: Difficulty distinguishing draft and final reports poses challenges related to volume and data currency
  • Prioritization - Inability to See Relevant Clinical Information: High report volumes make it difficult to identify relevant information. 

Review the recommendations in the EMR Usability report (pdf) 


Thank you to the following organizations who were engaged by or represented in the Task Force 

Ontario Hospital Association  Ontario Ministry of Health     College of Physicians and Surgeons of Ontario (CPSO)   Epic with patient healthMeditechOntario Health  Trillium Health Partners  The Ottawa Hospital | L'Hôpital d'Ottawa   TELUS Health   Ontario Medical Association (OMA)  WELL Health   Collingwood General and Marine Hospital  Childrens Hospital of Eastern Ontario (CHEO)

[1] College of Family Physicians of Canada

[2] Canadian Medical Association, 2021 National Physician Health Survey, p. 15 (PDF)