CMS, ONC unveil new strategy to reduce burdens in EHRs

The draft plan addresses physician concerns around usability, regulation and note bloat, and aims to help vendors improve their designs to improve productivity and user satisfaction.
By Benjamin Harris
01:57 PM
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The U.S. Department of Health and Human Services, through ONC and CMS, has released its draft strategy on reducing regulatory and ease-of-use burdens in electronic health records.

While EHRs have countless benefits, physicians have made clear their long-simmering frustration with the layers of documentation and regulatory requirements they have to meet – which adversely impacts the time they have to interact with patients. The 21s Century Cures Act, therefore, required HHS to examine the issue and develop a strategy to respond to it.

WHY IT MATTERS
Because so much documentation is now required in healthcare and because EHRs make it so easy to enter more data through templates, checkboxes and copy and pasting, many systems are experiencing note bloat.Many care providers say they're often spending more time entering data into the EHR than they are practicing medicine.

Additionally, the profusion of unnecessary notes make it much more difficult to find relevant patient information.

This draft strategy acknowledges that while the amount of information at physician fingertips is greater than it ever has been, work still needs to be done to improve EHR design and to reduce the time and reporting requirements for data entry. It lays out "three overarching goals designed to reduce clinician burden," as ONC and CMS noted in a Nov. 28 blog post:

  • Reduce the effort and time required to record health information in EHRs for clinicians;
  • Reduce the effort and time required to meet regulatory reporting requirements for clinicians, hospitals, and health care organizations; and
  • Improve the functionality and intuitiveness (ease of use) of EHRs.

"Electronic health records have several advantages over paper-based records, from improving continuity of care during a natural disaster to enabling more reliable prescribing," said Dr. Andrew Gettinger of ONC and Dr. Kate Goodrich, of CMS in the co-written post. "While EHRs can also improve care delivery, quality, and outcomes, many clinicians have told us, and their members of Congress, that EHRs can make it difficult to provide effective patient care."

THE LARGER TREND
Despite their required use and the promise that they will modernize healthcare, many EHRs are still struggling to be more functional and intuitive. Hospitals and health systems that implement them well can cut costs and improve care – as long as they do so with physician input.

Because of the distractions they can present in the form of poor information design or pop-up alerts, electronic systems can actually become more burdensome than the traditional pen and paper method of record-keeping. If these encumbrances aren’t properly addressed, they can even lead to safety risks for patients.

ON THE RECORD
"Information technology has automated processes in every industry except health care, where the introduction of EHRs resulted in additional burden on clinicians," said Dr. Don Rucker, national coordinator for health information technology, in a statement, calling for public input on the draft plan. "Health IT tools need to be intuitive and functional so that clinicians can focus on their patients and not documentation."

"With the significant growth in EHRs comes frustration caused, in many cases, by regulatory and administrative requirements stacked on top of one another," added HHS Secretary Alex Azar. "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."

Benjamin Harris is a Maine-based freelance writer and and former new media producer for HIMSS Media.
Twitter: @BenzoHarris.