Physicians’ woes with electronic health record systems are well documented. According to a study recently published in the Annals of Internal Medicine, physicians spent roughly 16 minutes per patient encounter with an EHR systems.
The Department of Health and Human Services released a strategy on Monday to ease that burden, and hopefully reduce screen time for doctors. As part of the 21st Century Cures Act, HHS was tasked with making EHRs easier to use, reducing the amount of time providers spend recording information, and reducing the time and effort it takes to meet regulatory reporting requirements.
“We will all be patients at some point in our lives and owe it to our dedicated clinical colleagues to improve the administrative, regulatory, and technological environment in which they work,” Dr. Donald Rucker, chief of the Office of the National Coordinator for Health Information Technology (ONC), wrote in a letter with the recommendations. “We are excited to put forward the HHS strategy and recommendations to help clinicians get back to what they do best—the healing arts.”
The ONC and Centers for Medicare and Medicaid Services reviewed more than 200 comments in the past year before putting together the recommendations.
“Many existing documentation requirements were crafted with paper-based systems and acute or chronic single-system medical problems in mind. They have not been updated to account for the current integration of health IT systems, increased complexity of patients and treatment options, and the increased need for longitudinal, coordinated care,” HHS wrote in the report. “At the same time, health IT solutions have not adequately addressed a range of administrative processes health care providers face — for example, prior authorization processes, where effective electronic automation could significantly reduce physician and organizational burden.”
HHS noted that many physicians also struggle with information overload, as all of a patient’s information is displayed, rather than tailored information to what a particular specialist might need. For example, a respiratory therapist might want to view a patient’s respiratory status and inhaler treatments from the past two days, while a physician in an emergency room would want to view a patient’s last imaging study. Most of the time, this information is displayed in a chronological, episodic fashion, rather than a comprehensive view of a patient’s health history.
“Locating pieces of information quickly within the massive data store of EHRs can be challenging if the EHR is not designed with the user in mind, increasing the burden on clinicians,” the report noted.
One of the recommendations suggested by the report was to make health IT systems easier to use by creating a common interface, so that clinicians don’t have to use a significantly different interface when they switch between systems. HHS also recommended standardizing documentation for prior authorization, by identifying a common template that developers could use to simplify this process.
Other approaches included changing regulatory requirements to simplify physician reporting. For example, HHS wants to reduce “note bloat,” where clinicians record unnecessary information from a patient visit to meet billing requirements. CMS Administrator Seema Verma said the agency overhauled its Promoting Interoperability programs and Merit-based Incentive Programs (MIPS) to reduce the reporting burden for physicians and promote the sharing of health information between providers and patients.
“The overhaul of the programs was the first step in achieving our interoperability objectives and addressing the recommendations in this report that also seek to enhance agency goals of interoperability and reduced EHR-related burden across the health care community,” Verma wrote in a letter attached to the report.
The agency’s changes to evaluation and management documentation, an overhaul of reporting requirements that are more than two decades old, will go into effect starting in 2021. The changes are expected to reduce the amount of time that physicians spend entering data after hours and on weekends.
Rucker said patients will ultimately benefit from these efforts, “…because their physicians will spend more time focused on them instead of their keyboards.”
Photo credit: Creativeye99, Getty Images