A recent op-ed in The New York Times urged doctors and nurses to unite in their demands for less time yoked to the EHR, which the authors noted now accounts for a full 50% of the workday.
This is a concerning statistic for health plan executives—who require much of the documentation that consumes clinicians’ workdays. It’s especially important to payers that are evolving their business model by acquiring provider organizations. While there may be limits to what these entities can do to change documentation requirements, the entire healthcare industry can work together to help clinicians get more value from EHRs while spending less time on them.
Make care coordination a practice-wide capability
Clinicians will depend on EHRs for the foreseeable future, but they need not stay tethered to them, experts say. Many health plans are now equipping medical and behavioral healthcare practices in their networks with shared platforms for care coordination, including for complex populations.
“An unintended consequence of the industry’s shift to implement EHR systems is that the physician has, in many ways, become the bottleneck,” says Doug Duskin, president of HealthBI, the technology division of integrated delivery system Equality Health. “Time that would otherwise be spent with their patients is now spent on managing clinical documentation. This is where care coordination platforms play a critical role, by sharing actionable information across the practice—including identified preventive gaps, chronic conditions, and recommended next steps in care.”
Unlike EHRs, at least as they were originally designed and deployed, these platforms can be used by practice staff as a daily tool for value-based or preventive care coordination, Duskin says. This takes a tremendous burden off physicians, even while giving a new ability to take on more risk—and to move the needle on persistently poor health.
Duskin notes the underlying benefit of technology that enables practice staff to consume and act on information from the care coordination platform. “It’s empowering those who support the physician to share in managing the practice’s day-to-day workflow. In turn, that allows physicians to shift their focus back, once again, to the patient,” he explains.
More data consumption, less data entry
As a nurse with years of experience in the profession in hospitals and in the Army, Dana Bensinger has strong opinions about how clinicians should be spending their time. And it’s not in front of the screen for the better part of a day.
“Shortcomings in interoperability, combined with the increased documentation requirements for payment, has turned nurses and doctors into data entry people. In reality, they are supposed to be data consumers,” notes Bensinger, who today leads EHR implementation and optimization projects at IT solutions consultancy CTG.
A primary care doctor should not have to enter the date of a diabetic patient’s last eye exam, Bensinger adds. Likewise a nurse should not be manually entering vital signs. “That data should be automatically pulled into the EHR from a source system and eliminate the need to document it,” says Bensinger.
To reduce documentation burnout, Bensinger says to: “Take stock of who is collecting what data. Then determine if they should even be collecting certain data rather than acquiring it from other sources. When CIOs or CMIOs are asked to add data elements to the EHR, they should first ask ‘where can we get this data?’—not ‘who is going to collect it,’” Bensinger advises.