When the 21st Century Cures Act was signed into law nearly three years ago, the goal was to “help accelerate medical product development and bring new innovations and advances to patients who need them faster and more efficiently (FDA).” And it has, through provisions pushing for interoperability and EHR adoption.
However, with the advancement of health IT initiatives came an unintended consequence: an added burden on physicians, nurses, and other users. What healthcare IT leaders and rule makers quickly learned was that it isn’t necessarily the tools that have led to frustration, but the regulatory requirements, said Andy Gettinger, Chief Clinical Officer at ONC, during a presentation at the CHIME Advocacy Summit.
Not surprisingly, the chief burdens identified were billing-related documentation (also known as “note bloat”), prior authorization, quality measurement, poor user experience with clinical workflow, too much time outside of patient care spent on electronic records, and PDMPs poorly integrated into EHRs.
To that end, a draft was created focusing specifically on reducing the burden on clinicians — and not, as Gettinger noted, just physicians — that outlines several strategies for addressing pain points through collaboration with government agencies, payers, and provider organizations.
The strategies are grouped into four categories, with specific aims assigned to each.
Health IT usability & the user experience
- Improve alignment of EHRs with clinical workflow
- Promote user interface optimization in health IT
- Promote harmonization surrounding clinical content contained in health IT
- Promote the importance of implementation decisions
Public health reporting
- Better integration of prescribing controlled substance and usage of state PDMP with EHR workflow
- Harmonize and simplify federal and state public health reporting requirements
- Simplify program reporting and participation requirements
- Reduce administrative and financial burdens associated with quality and EHR reporting programs
- Improve electronic clinical quality measures
- Reduce regulatory burden around documentation requirements for patient visits
- Clinician partnership – documentation best practices
- Reduce documentation burden tied to prior authorization
“The reality is that the EHR will never be as simple as using an iPhone,” said Gettinger. In fact, it’s more akin to navigating the cockpit of a jet.
The good news is that by taking the time for advocacy, whether it’s testifying on the Hill, submitting comments, or reviewing regulations, CIOs and other leaders can help make the EHR more user-friendly. Gettinger and his colleagues from ONC advised leaders to look at for the final report, which is scheduled to be released by the end of 2019.