HHS Aims to Reduce Burden of Cumbersome Health IT Infrastructure

November 29, 2018 - HHS has issued a draft strategy designed to reduce administrative and regulatory burdens, which can make health IT infrastructure, such as electronic health records (EHR), cumbersome to use.

Administrative and regulatory requirements imposed on EHR are causing “frustration” for clinicians, said HHS Secretary Alex Azar in releasing the draft.

“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,” Azar said.

The draft strategy reflects the input and feedback received by the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services from stakeholders, including clinicians, expressing concerns that the EHR burden negatively affects the end user and ultimately the delivery of care.

“Information technology has automated processes in every industry except health care, where the introduction of EHRs resulted in additional burden on clinicians,” said National Coordinator for Health Information Technology Don Rucker.

“Health IT tools need to be intuitive and functional so that clinicians can focus on their patients and not documentation. This draft strategy identifies ways the government and private sector can alleviate burden,” Rucker added.

HHS explained that the 21st Century Cures Act required the agency to identify ways to reduce regulatory and administrative burdens related to EHR use.

“Over the past several decades, health IT use has dramatically changed the practice of medicine and clinical care in the United States … There is a growing consensus that, while it has made an unprecedented amount of information about patients available to them, technology has yet [to] make the practice of medicine easier for physicians and other healthcare professionals,” the draft strategy observed.

“We have heard from healthcare 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. These challenges affect productivity, increase organizational cost, and detract from patient focus, resulting in negative experiences using health IT,” it added.

The draft strategy includes recommendations that will allow physicians and other clinicians to provide effective care to their patients:

• Improve usability through better alignment of EHRs with clinical workflow and improve decision making and documentation tools
• Promote user interface optimization in health IT that will improve the efficiency, experience, and end user satisfaction
• Promote harmonization surrounding clinical content contained in health IT to reduce burden
• Improve health IT usability by promoting the importance of implementation decisions for clinician efficiency, satisfaction, and lowered burden
• Address program reporting and participation burdens by simplifying program requirements and incentivizing new approaches that are both easier and provide better value to clinicians
• Leverage health IT functionality to reduce administrative and financial burdens associated with quality and EHR reporting programs
• Improve the value and usability of electronic clinical quality measures while decreasing health care provider burden
• Increase adoption of electronic prescribing of controlled substances and retrieval of medication history from state PDMP through improved integration of health IT into health care provider workflow
• Inventory reporting requirements for federal health care and public health programs that rely on EHR data to reduce collection and reporting burden on clinicians
• Focus on harmonizing requirements across federally funded programs that impact a critical mass of healthcare providers

“Over the past year, ONC and CMS brought together stakeholders who shared feedback on possible opportunities to reduce burden and make EHRs more usable. The draft strategy reflects this input received through several wide-reaching listening sessions, written input, and other stakeholder convenings,” ONC Chief Clinical Officer Andrew Gettinger and CMS Chief Medical Officer Kate Goodrich wrote in a blog post.

The public comment period on the draft strategy ends on January 28, 2019, at midnight.