HHS outlines broad plan to reduce EHR burden
- HHS on Wednesday released a draft strategy aimed at relieving clinicians of some of the administrative and regulatory burdens associated with use of EHRs and other health IT.
- The 74-page playbook focuses on three broad goals to cut back on clinician burden: reducing time and effort tied to both regulatory reporting requirements and inputting patient information in EHRs, and increasing functionality and user-friendliness of EHRs.
- The HHS Office of the National Coordinator for Health Information Technology developed the strategy in conjunction with CMS to meet a requirement of the 21st Century Cures Act.
Less burden from EHRs is high on the wish list for providers and healthcare executives. Repeated studies have shown administrative burden to be a leading cause of physician burnout, and the problem is getting worse, not better. A recent JAMA study found nearly half of resident physicians experience burnout, while a separate study showed four in 10 doctors hold pessimistic views of the practice of medicine.
"With the significant growth in EHRs comes frustration caused, in many cases, by regulatory and administrative requirements stacked on top of one another," HHS Secretary Alex Azar, said in a statement accompanying the guidance. "Addressing the challenge of health IT burden and making EHRs useful for patients and providers, as the solutions in this draft report aim to do, will help pave the way for value-based transformation."
Organizations are also looking at their EHR capabilities and functionalities, with 38% of CIOs calling EHR optimization their organization's chief investment priority — ahead of accountable care and population health technologies.
The draft strategy cites a plethora of sources of EHR and health IT-related burden, including misalignment of regulatory requirements and timelines across programs, problems accessing and extracting data from systems supporting reporting and records becoming overloaded with extraneous documentation.
The document breaks the challenges into four categories — clinical documentation, health IT usability and the user experience, EHR reporting and public health reporting. Among the recommendations for reducing burden are:
- Leverage existing data in EHRs to reduce redocumentation in clinical notes
- Waive documentation requirements as necessary to test or administer alternative payment models
- Work with payers and other groups to support pilots for standardized electronic ordering of services
- Coordinate efforts to advance new standards approaches supporting prior authorization
- Better align EHR design with real-world clinical workflow
- Harmonize user actions for basic clinical operations across EHRs
- Standardize medication information and order entry content within health IT
- Improve health IT measures and develop new measures that focus on interoperability
- Incentivize innovative uses of health IT and interoperability that reduce reporting burdens and increase value for physicians
- Deploy an open API approach to HHS electronic administrative systems to advance integration with health IT products
- Harmonize reporting requirements across federally funded programs requiring the same or similar EHR data from providers
Health IT Now — a broad-based coalition of providers, payers, employers and patient groups — praised the new strategy, calling ONC's acknowledgement of the significant burdens around EHR reporting, clinical documentation and health IT usability generally a "worthy first step."
The group released a joint white paper earlier this year with the Bipartisan Policy Center outlining similar goals.
"We look forward to our continued engagement with ONC throughout this process and to finalization and implementation of a robust burden reduction strategy that helps, rather than hinders, clinicians' ability to provide patient-centered, 21st-century care," Joel White, executive director of Health IT Now, said in a statement.