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February 17, 2018 12:00 AM

Week ahead: ONC and CMS seek to understand clinician tech burden

Rachel Z. Arndt
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    Dr. John Fleming, deputy assistant secretary for health technology reform at the ONC

    Clinicians complain about logging into electronic health records dozens of times a day. They complain about clunky navigation and undue documentation requirements that keep them from engaging with patients. They and others will air their grievances this week during a meeting hosted by the CMS and the Office of the National Coordinator for Health Information Technology.

    Under the 21st Century Cures Act, the two agencies are required to document the burden that comes from clinical practice and EHRs and recommend how to reduce that burden. To meet that requirement, they're holding a "reducing clinician burden meeting" on Feb. 22 in Washington that participants can join in person or by phone.

    "We're trying to understand the origin of the burden," said Dr. John Fleming, deputy assistant secretary for health technology reform at the ONC and one of the facilitators of this week's meeting. "Even though EHRs are what doctors yell at and sometimes throw things at, they're not really the underlying cause of the problem."

    Some of the problem comes from regulations that have "stacked up" over the years, Fleming said. Physicians spend a good chunk of their days working in EHRs, with ambulatory physicians dedicating more than a third of their time with patients on EHR and desk work tasks, according to a recent study.

    The expectation was that technology would make things better, but in some cases, it's making things worse, with many clinicians overwhelmed by so-called "note bloat."

    At the meeting, ONC and CMS officials hope to learn about providers' priorities for decreasing the burden. "We hope to achieve some level of understanding by crowdsourcing in our program what are the key problems and what are the key solutions," Fleming said.

    Representatives from the American Medical Association and the American Health Information Management Association say they look forward to hearing others' thoughts at the meeting. "We plan to stress the unique needs of small practices," AMA President Dr. David Barbe said.

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