February 27, 2020

Reducing your EHR Burden

I’m sure when you decided to become a doctor you didn’t envision spending hours each day in front of a computer entering information into electronic health records (EHRs). Unfortunately, it’s become an integral part of ensuring you get paid and meet certain quality reporting requirements. In all, EHR use is a major contributor to physician burnout, which is why reducing the burden associated with EHRs is a top priority for ACEP.

Recently, the U.S. Department of Health and Human Services (HHS)’s Office of the National Coordinator (ONC) for Health Information Technology issued a final report outlining its plan for reducing regulatory and administrative burden relating to the use of EHRs. The report focuses on strategies aimed at:

  1. Minimizing the effort and time required to record information in EHRs;
  2. Reducing the time it takes to meet all the regulatory reporting requirements; and
  3. Improving the functionality and ease of use of EHRs.

The strategies are broken down into four burden areas: clinical documentation, health IT usability, EHR reporting, and public health reporting. Within each area, ONC lists the steps that HHS has already taken to help reduce burden and then provides specific recommendations for further action.

I believe that many of the recommendations, if implemented, would be useful for physicians in general. ONC wants to waive documentation requirements that may be necessary to test alternative payment models. HHS, including the Centers for Medicare & Medicaid Services, is also examining ways to streamline prior authorization processes and better align the way EHRs are designed with real-world clinical workflow. Further, HHS wants to make it easier to meet quality reporting requirements by encouraging the use of electronic quality measures and making current programs, such as the Merit-based Incentive Payment System (MIPS) , more meaningful for physicians. Finally, HHS wants to improve interoperability of EHRs and prescription drug monitoring programs (PDMPs). With respect to PDMPs, one strategy included in the report is for federal stakeholders to work with states on ways to increase queries from state PDMPs.

While these recommendations are a good start, there are a few areas that I wished ONC would have addressed in the final report. When ONC issued its draft report in November 2018, ACEP submitted detailed comments on actions that HHS could take to reduce burden for emergency physicians specifically. As hospital-based physicians working in emergency departments, rarely do you have access to all your patients’ data, and you may be forced to make life and death decisions with incomplete information. In addition, meeting MIPS reporting requirements may be more difficult for emergency physicians since you rely on receiving data from your hospitals to fully report. For example, a large number of emergency physicians and groups that use ACEP’s qualified clinical data registry, the Clinical Emergency Data Registry (CEDR), to report quality measures do not receive any data from their hospitals. Although we asked ONC to address these issues in the final report, the office did not do so.

Fortunately, we’ll have at least one more shot at directly engaging with ONC on EHR burden issues specific to emergency physicians. Dr. Donald Rucker, who leads ONC and is an emergency physician, will be speaking at our Leadership and Advocacy Conference (LAC) at the end of April. We encourage you to attend LAC and hear directly from Dr. Rucker on what more ONC and HHS can do to reduce your burden and address the major concern that using EHRs is contributing to physician burnout.

One last final announcement, we are broadening our Regs and Eggs menu items to now include a podcast. So for those of you who prefer your Regs & Eggs to go, you can click here to listen to the weekly update at your convenience.

Until next week, this is Jeffrey saying, enjoy reading....or hearing about...regs with your eggs.

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