The healthcare industry has been ready for an overhaul of the Meaningful Use program, and CMS Administrator Seema Verma announced at the HIMSS18 conference this month that the agency is prepared to deliver. What can physicians expect? An increased focus on interoperability that provides timely access to health information combined with updated and streamlined evaluation and management (E/M) billing requirements that will allow physicians to spend less time using their EHRs and more time seeing patients.
This all bodes well for physicians—particularly those who continue to struggle with productivity when using EHRs. Forty-six percent of practices report seeing fewer patients now that they have an electronic record. It’s easy to blame the EHR for this problem. Yet, in every other industry, technology has only made people more efficient. Why hasn’t this happened in healthcare?
To understand the answer to this question, we need to examine the background against which physicians have implemented EHRs. First, providers practice in a highly regulated healthcare environment. Documentation is their greatest asset because it drives payment and publicly reported outcomes data. This wasn’t the case pre-EHRs when most physicians talked briefly with patients, performed a quick exam, scribbled a few words on a piece of paper, and moved on to their next patient. For the most part, payers paid regardless of the words physicians used to describe their services.
Now, payer requirements are far more stringent, and physicians must meet a whole host of quality metrics to be paid accurately. It’s a different world. For every hour that physicians spend with patients, they spend two hours on EHRs and desk work. Thirty-eight percent of physicians spend 10-19 hours per week on paperwork.
Second, providers practice in a highly litigious environment absent of medical liability tort reform. Physicians often document information that may not even be clinically relevant out of fear that they’ll be sued for medical malpractice and owe excessive amounts of money. The more time physicians spend documenting, the less time they spend seeing patients.