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AAFP recommends steps to reduce health IT regulations

The American Academy of Family Physicians has recommended steps to relieve the burden of health IT regulations on physicians.

In a letter to CMS administrator Seema Verma and ONC national coordinator Don Rucker, the AAFP stated that the “current regulatory framework with which primary care physicians must comply is daunting and often demoralizing.”

The organization also said providers “spend needless hours reviewing documents and literally checking boxes to meet the requirements of each health insurance plan” — time that could be spent with patients.

The letter reiterates an issue raised by former Health and Human Services secretary Tom Price at the Health Datapalooza Conference in Washington, D.C. last year. At the time, Price said that while data is essential to providing better care to patients, physicians need to be patient-facing and not just computer-facing.

Price also lamented that the burden of health IT regulations in systems such as EHRs was causing current physicians to want to retire earlier than physicians of past generations.

In a study in its journal, Annals of Family Medicine, the AAFP found that clinicians spend nearly two hours on EHR tasks for each hour of direct patient care. The AAFP also said that clinicians spent almost six hours of an 11 and a half hour workday in the EHR per workday.

The study echoes one previously conducted by the Mayo Clinic that found that EHR use may be causing physician burnout, particularly in terms of computerized orders, and that EHRs have failed to improve efficiency.

The AAFP recommended seven principles to reduce the amount of health IT regulations physicians face daily.

  • Minimize health IT utilization measures — Analyze policies that mandate or financially penalize physicians’ prescribed use of health IT to assess the benefit and burden in real-word usage before they are put in place
  • Medical record documentation — Medical record documentation should focus on recording essential elements of a patient encounter and sharing that information with other providers
  • Focus interoperability policy on information blocking and how data is to be exchanged — Policies should be centered around ensuring standards-based capabilities for information exchange
  • Lack of standard representation of clinical data models — Create consistent data templates, led by physicians and clinicians
  • Prior authorization — Activities that require prior authorization should be justified in terms of financial recovery, and should be eliminated for physicians with aligned financial incentives
  • Quality measures and the need for measure harmonization — Measures should focus on improving process and care outcomes in terms that matter to patients
  • Certification and documentation — The physician’s order should be sufficient for patients to receive certain services and not require them to sign multiple forms

Verma and Rucker will both be presenting at the 2018 HIMSS conference in Las Vegas on March 6.

Verma’s morning session will address her efforts at CMS to advance interoperability and patient ownership of healthcare data. In his evening fireside chat, Rucker will discuss the 21st Century Cures Act and how ONC is working to improve health IT interoperability and usability.

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