EHR Relief in Sight? HHS Issues Draft Strategy to Reduce Health IT Burdens

Opportunity for public commentary is open through January 28.

The regulatory and administrative demands electronic health records (EHRs) place on clinicians are about to get a do-over. The U.S. Department of Health and Human Services (HHS) has issued a draft strategy designed to help reduce the burden caused by the use of health information technology, such as EHRs.

Public commentary on Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs is open through Jan. 28, providing an opportunity for health systems and other interested stakeholders to mold the final document. Development of the draft was led by the Office of the National Coordinator for Health Information Technology (ONC), in partnership with the Centers for Medicare & Medicaid Services (CMS), as required by Congress under the 21^st Century Cures Act.

“Usable, interoperable health IT was one of the first elements of the vision I laid out earlier this year for transforming our health system into one that pays for value,” said HHS Secretary Alex Azar in a news release.

Azar expands on the issue in the opening message of the report. "HHS believes that the types of EHR and health IT-related burden identified in this report hinder the achievement of this vision of interoperability," he says. As a result, clinicians must invest additional time, which reduces the value of information, diverts clinical and financial resources from patient care, impedes innovation, and limits potential gains in improved quality of care for patients and patient safety.

The draft strategy outlines three overarching goals designed to reduce clinician burden:

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

Excerpts related to recommended strategies appear below. The full draft is available online as well as a blog post by representatives of ONC and CMS.

Clinical Documentation Strategies
 

To reduce the burden of clinical documentation into the EHR, HHS is considering reforming a variety of administrative processes. Recommended strategies include:

• Reduce regulatory burden around documentation requirements for patient visits
   
• Continue to partner with clinical stakeholders to encourage adoption of best practices related to documentation requirements
   
• Leverage health IT to standardize data and processes around ordering services and related prior authorization processes

Health IT Usability Strategies and The User Experience
 

Recommendations address how improvements in the design and use of health IT systems can reduce EHR usability-related burden for clinicians, requiring collaboration across a range of stakeholders, including clinicians, health IT developers, other vendors, HHS, and other institutional stakeholders. Among the recommended strategies:

• Improve usability through better alignment of EHRs with clinical workflow; 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

EHR Reporting Strategies
 

Programmatic, technical, and operational challenges raised by stakeholders to reduce EHR-related burden associated with program reporting will be addressed by the following strategies:

• 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

Public Health Reporting Strategies
 

The final set of strategies addresses topics linked to federal, state, local, territorial, and tribal government policies and public health programs. These strategies include:

• Increase adoption of Electronic Prescribing of Controlled Substances (EPCS) and retrieval of medication history from state Prescription Drug Monitoring Programs (PDMPs) through improved integration of health IT into 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 health care providers.