Rules, paperwork burdens 'untenable' for family physicians, report says
- The American Academy of Family Physicians is calling on the federal government to reduce regulatory and administrative burdens on doctors, including by standardizing authorization forms across payers.
- In a Feb. 7 letter to CMS Administrator Seema Verma and Don Rucker, national coordinator for health IT, the group called the current regulatory framework with which physicians must comply “daunting and often demoralizing.”
- AAFP laid out seven principles to help simplify requirements and administrative workload.
Study after study has shown physician burnout to be a huge problem, and the leading cause is the time required for administrative tasks. A study in the Annals of Family Medicine last year found physicians spend nearly six hours a day interacting with EHRs, spilling over into after-clinic hours.
A 2016 study in the journal found doctors spend just under half their workday on EHRs and administrative tasks and only 27% of their time seeing patients. Even in the examination room, physicians spend more than a third of their time on computer and administrative tasks.
The AAFP letter follows a joint CMS-ONC meeting to address clinician burden, part of the Patients over Paperwork Initiative. Another meeting is scheduled for Feb. 22.
“Despite the good intent of underlying health care policies, the burden on the practicing physician has expanded to an untenable level and is a significant barrier to achieving the Quadruple Aim of enhancing patient experience, improving population health, reducing costs, and improving the work life of clinicians and staff,” the letter states.
To ease the administrative burden, AAFP recommends the following:
- Minimize health IT utilization measures and ensure policies that mandate physician use of health IT are assessed both for benefit and burden in real-world practice.
- Reduce medical record documentation, in particular CMS’ documentation guidelines for evaluation and management services, which “serve more as a crutch to justify billing levels … than to help physicians diagnose, manage, and treat patients.”
- Focus interoperability policy on information blocking and how data is exchanged, and align financial incentives to encourage interoperability as a business strategy.
- Standardize clinical data models, letting physicians and other clinicians take the lead rather than policymakers and vendors.
- Reduce requests for prior authorization.
- Ensure quality measures are practical and focus on “improving processes and outcomes of care in terms that matter to patients.”
- Reduce certification and documentation requirements from outside entities for patient services and supplies and standardize forms across payers.