- HHS issues new report outlining the key sources of EHR-related burden, as well as strategies and recommendations to achieve burden reduction goals for healthcare providers.
- The HHS report reflects additional input from the more than 200 comments submitted in response to the draft strategy and recommendations.
s part of the ongoing efforts to strengthen the relationship between patients and their doctors, the U.S. Department of Health and Human Services (HHS) issued the Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs. The report describes examples of electronic health record (EHR) related burden, as well as strategies and recommendations that HHS and other stakeholders can use to help clinicians focus their attention on patients rather than paperwork, when they use health information technology.
The development of the report, required under the 21st Century Cures Act, was led by the HHS Office of the National Coordinator for Health Information Technology (ONC) in conjunction with the Centers for Medicare & Medicaid Services (CMS). The initial draft, issued in November 2018, represented HHS’s assessment and response to feedback heard from a wide variety of health IT stakeholders, from practicing clinicians to health IT developers.
3 Primary Goals
The report released additional input from the more than 200 comments submitted in response to the draft strategy and recommendations. The report outlines three primary goals and offers recommendations to:
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1. Reduce the effort and time required to record information in EHRs for healthcare providers when they are seeing patients;
2. Reduce the effort and time required to meet regulatory reporting requirements for clinicians, hospitals, and healthcare organizations; and
3. Improve the functionality and intuitiveness (ease of use) of EHRs.
Strategies & Recommendations to Mitigate EHR-Related Burden
The report explains that different types of administrative burden can affect different healthcare providers, but is focused on those healthcare providers that are directly involved in the delivery of patient care. Those may include physicians, nurses, and other clinical staff; practice managers and other administrators immediately engaged in the management of care delivery; and care delivery institutions, such as hospitals.
Based on the issues and challenges described, the HHS report lays out a series of strategies and recommendations that HHS is considering taking to mitigate EHR-related burden for healthcare providers.
Specifically, ONC and CMS looked at four key areas and offered strategies to address each area:
Strategy 1: Reduce regulatory burden around documentation requirements for patient visits.
Strategy 2: Continue to partner with clinical stakeholders to encourage adoption of best practices related to documentation requirements.
Strategy 3: Leverage health IT to standardize data and processes around ordering services and related prior authorization processes.
Health IT usability (or ease of use of health IT tools and systems)
Strategy 1: Improve usability through better alignment of EHRs with clinical workflow; improve decision making and documentation tools.
Strategy 2: Promote user interface optimization in health IT that will improve the efficiency, experience, and end-user satisfaction.
Strategy 3: Promote harmonization surrounding clinical content contained in health IT to reduce burden.
Strategy 4: Improve health IT usability by promoting the importance of implementation decisions for clinician efficiency, satisfaction, and lowered burden.
Federal health IT and EHR reporting requirements
Strategy 1: Address program reporting and participation burdens by simplifying program requirements and incentivizing new approaches that are both easier and provide better value to clinicians.
Strategy 2: Leverage health IT functionality to reduce administrative and financial burdens associated with quality and EHR reporting programs.
Strategy 3: Improve the value and usability of electronic clinical quality measures while decreasing healthcare provider burden.
Public health reporting (including coordination with prescription drug reporting programs and electronic prescribing of controlled substances).
Strategy 1: Increase provider PDMP query for the retrieval of medication history from a state PDMP. Improve healthcare provider workflow for conducting the query by integrating the PDMP with health IT.
Strategy 2: HHS should increase adoption of electronic prescribing of controlled substances (EPCS) with consideration for provider-specific preferences, workflow, and use of available standards.
Strategy 3: Develop a process to address the issue of inconsistent data collection by federal, state, and local programs.
Strategy 4: HHS should expand upon existing guidance about HIPAA privacy requirements and federal confidentiality requirements governing substance use disorders (SUDs) health information in order to better facilitate electronic exchange of health information for patient care.
“The taxpayers made a massive investment in EHRs with the expectation that it would solve the many issues that plagued paper-bound health records,” said CMS Administrator Seema Verma. “Unfortunately – as this report shows – in all too many cases, the cure has been worse than the disease. Twenty years into the 21st century, it’s unacceptable that the application of Health IT still struggles to provide ready access to medical records – access that might mean the difference between life and death. The report’s recommendations provide valuable guidance on how to minimize EHR burden as we seek to fulfill the promise of an interoperable health system.”