ONC unveils new plan for combating clinician burnout

Its Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs aims to make changes that allow providers to focus on patients.
By Mike Miliard
03:59 PM

CMS Administrator Seema Verma and National Coordinator for Health IT Dr. Donald Rucker

With a new report from the U.S. Department of Health and Human Services, drawn up as required by the 21st Century Cures Act, the agency puts forth its plan to help alleviate the burden of documentation and reporting requirements, and boost EHR usability.

WHY IT MATTERS
The strategic plan, developed by the Office of the National Coordinator for Health IT, with input from the Centers for Medicare & Medicaid Services, offers a series of recommendations to help clinicians focus their attention on patients and not administrative tasks.

The report lists three primary goals:

  • Reduce the effort and time required to record information in EHRs for health care providers when they are seeing patients;
  • 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.

"The strategy we are releasing today takes a hard look at ways that the federal government and stakeholders can work together to reduce the administrative and technological burdens experienced by healthcare providers," said National Coordinator Dr. Don Rucker in a statement. "Patients will benefit from these efforts because their physicians will spend more time focused on them instead of their keyboards."

The report acknowledges many types of administrative burden, but it focuses on providers who are directly involved in care delivery: physicians, nurses, clinical staff, practice managers and hospital staff engaged with patient care.

ONC and CMS look at four problem areas and offered strategies to improve them:

  • Clinical documentation 
  • Health IT usability 
  • Federal health IT and EHR reporting requirements 
  • Public health reporting, including coordination with prescription drug reporting programs and electronic prescribing of controlled substances.

"Although clinicians and other health care providers point to the implementation, use, and regulation of health IT and the EHR as a key support tool for care delivery, it remains a source of ongoing frustration," said HHS officials in the 73-page report. "They argue that the EHR has introduced new challenges or failed to address existing ones despite intending to improve the practice and experience of medicine.

"We have heard from health care providers, practice managers, and hospitals that they experience challenges with EHR system design and the regulatory and administrative burdens associated with the use of EHRs during care delivery, required reporting activities, and documentation of claims for payment," they added. "These challenges affect productivity, increase organizational cost, and detract from patient focus, resulting in negative experiences using health IT."

THE LARGER TREND
The development of this report follows an initial draft issued in November 2018. Since then, CMS, as part of its Patients Over Paperwork initiative unveiled its Omnibus Burden Reduction Final Rule, aimed at combating clinician burnout.

While it's true that "burnout is multifactorial," as the chief information officer at UCLA Health noted at Health 2.0 this past September, excessive federal documentation requirements and suboptimal technology design are major exacerbating factors – as borne out by a recent Mayo Clinic study that found a "strong dose-response relationship between EHR usability and the odds of burnout."

ON THE RECORD
"Usable, interoperable health IT is essential to a healthcare system that puts the patient at the center, like President Trump has promised," said HHS Secretary Alex Azar in a statement. "We received feedback from hundreds of organizations and healthcare providers on this new burden-reduction strategy, and the input made clear that there are plenty of steps still necessary to make IT more usable for providers and maximize the promise of electronic health records."

"The taxpayers made a massive investment in EHRs with the expectation that it would solve the many issues that plagued paper-bound health records," added 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 recommendationsprovide valuable guidance on how to minimize EHR burden as we seek to fulfill the promise of an interoperable health system."

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

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