80% of Clinicians Use a Workaround Every Day. Look at What They're Working Around.

Ask a charge nurse what she keeps on paper and she will usually tell you without hesitating. A folded index card. A running list in a notes app. A column in a spreadsheet that only she updates. She can tell you exactly what is on it, why it is there, and what would go wrong if she stopped keeping it.

That list is not a documentation habit. It is a tracking system she built because nothing else was tracking the thing she is responsible for.

A survey of 1,919 clinicians published in July by Black Book Research put a number on how common that is. In total, 80.7% reported using at least one workaround every day, and 65.2% said they lose 30 minutes or more per shift to avoidable digital work. The study ran nine months and was collected independently of EHR vendors, consultants, and payers.

The headline number is striking. But the more useful part of that survey is the list of what clinicians said they were doing manually.

The tasks clinicians named are not documentation tasks

Among the specific manual work respondents reported:

• 56% manually track laboratory results, imaging, referrals or authorizations
• 49% check payer portals outside the clinical workflow
• 42% manually reconcile outside records or medication lists
• 61% maintain side notes, scratch pads or unofficial task lists

Read that list again with an operational eye. Manually tracking a referral is not a charting gap — it is a handoff with no owner. Checking a payer portal on a loop is not a data-entry problem — it is a status that nobody pushes to you. Reconciling an outside medication list by hand is not a records issue — it is a transition between two organizations that never closed.

Every item on that list is a multi-step process that crosses roles, systems, or organizations. None of them are things an EHR was built to own, and none of them get solved by documenting faster. This is a coordination problem, not a communication problem — and clinicians have been absorbing it personally, one index card at a time.

Adding another tool is how the number got this high

The same survey found that 55.9% of clinicians use at least one paid digital tool that adds screens, queues, messages or review requirements without clearly removing a frontline task. More than half. Software that was purchased to reduce work is, by the users' own account, adding it.

That is the predictable result of treating coordination gaps as communication gaps. Communication platforms move messages well, but they cannot track a workflow that spans multiple steps, systems, and teams — so each new channel becomes one more queue to check. The nurse keeps her index card anyway, because the card is the only thing that knows whether the work actually got done.

It is worth being precise here. The teams building these workarounds are not behind — they identified a gap and filled it with what they had. We have written before about why workarounds are coordination infrastructure and why they break when the person who built them goes on leave. What the survey adds is scale: this is not a few units improvising. It is most of the clinical workforce.

What it takes to actually remove the work

Removing a task is different from relocating it. A workflow stops requiring a private tracking list only when the system itself holds the state — when the referral has a status, an owner, and an escalation path that fires without anyone remembering to check.

That is what a configured Pathway does. Referral tracking stops being a phone call and becomes a stage with an assigned role and a defined window. Prior authorization advances through submitted, pending, and resolved where the team can see it, rather than living in a portal someone refreshes between patients. When a stage stalls, it escalates instead of aging quietly on someone’s card.

None of that removes clinical judgment. The nurse still assesses. The authorization specialist still owns the submission. What it removes is the unpaid administrative work of being the system of record for a process the organization never structured — the part that produces relief for teams and visibility for operations at the same time.

And because no two organizations run these processes identically, the stages and windows have to reflect how your teams actually hand work off. Your workflows, your way. Coordination adapts with you.

The so-what

If 80% of your clinicians keep a private list, that list is telling you where your workflows have no owner. It is free operational data, and most organizations never collect it.

So collect it. Ask a unit what they track by hand and why. Then ask which of those items should have a status, an owner, and an escalation path instead of an index card. That inventory is usually a short list, and it is almost always the same list the survey found.

Backline Pathways gives that work a status, an owner, and an escalation path, so the tracking doesn’t have to live on an index card. See how it works across the Pathways use cases, or schedule a Workflow Assessment to talk through which of your workflows currently have no owner.

Black Book Research, clinician workflow survey (n=1,919), July 2026. Reported by Becker's Hospital Review, “Clinicians lose 30+ minutes a day to ‘invisible’ digital work,” July 14, 2026.