How payers, hospitals and tech vendors can make EHRs less burdensome

Recent research has suggested physicians spend half their time using EHRs, rather than on face-to-face patient care — and the annual cost of this time totals more than $365 billion, according to a recent op-ed in Harvard Business Review.

However, there are steps that healthcare industry players — including payers, hospitals and technology vendors — can take to reduce these burdens. Three healthcare experts — Avant-garde Health CEO Derek Haas, Boston-based Beth Israel Deaconess HealthCare CIO John Halamka, MD, and Danville, Pa.-based Geisinger System Services Chief Physician Officer Michael Suk, MD — outlined a few of these steps in an op-ed for Harvard Business Review.

Three steps to reduce EHR burdens, according to Mr. Haas, Dr. Halamka and Dr. Suk:

1. Standardize and reduce payer-imposed requirements. The average length of patient note in an EHR is 700 words, more than double what it was in 2009, because of documentation requirements imposed by payers. "[CMS] is beginning to make strides in reducing requirements with its 'Patients over Paperwork' initiative, and we believe that private payers should adopt the same principles and agree on a set of standards, requiring documentation only when it truly adds clinical value," the authors write.

2. Cut unnecessary tasks from EHRs and physician workflows. The authors note that "colleagues who have seen EHR implementations across multiple organizations estimate that there is the potential to improve workflows in the EHR by about 20 percent, on average, by removing steps that don't have any value." They add that, as part of optimizing EHRs and clinical workflows, organizations should also consider which clinicians or staff members are tasked with each activity to see if they can transition those roles to someone else — for example, whether the organization can shift some data-entry tasks to staff other than physicians.

3. Embrace innovation. The EHR user experience needs work, despite the emergence of tools like voice recognition and digital scribes. "We believe that third-party innovators have the most potential to dramatically improve both the user experience of clinicians and the health of patients," the authors note. "Key to enabling similar experiences and fostering further innovation will be the creation of stronger standards so developers do not need to rebuild their apps for each EHR."

"We are optimistic that better days are on the horizon for clinicians and that we are past the nadir of the EHR usability problem," the authors write. "Improvements will not occur automatically though, and there needs to be widespread recognition that physicians spending half their time using EHRs is a healthcare crisis that must be fixed."

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