Doctors listed the burden of paperwork / quality metrics as their top concern in the Medical Economics 89th Annual Physician Report.
Paperwork? I thought medicine was fully electronic? But there is now more administrative work rather than less as the shift to fully digital practices proceeds along the same lines as the shift to value-based care and its data requirements.
Physicians continue to struggle with all being asked of them. One driver of additional administrative work is the demand from the Merit-based Incentive Payment System (MIPS) to gather “essential” data. Another is to keep up with ever-changing demographic and insurance data for the practice.
None of this appears to have a direct benefit for the patient but it is necessary for the operation of the business. This is best tracked and housed in the electronic system(s) accessed daily.
A simple way to address additional administrative tasks is to talk about it at the clinician level. This communication would be built on evidence-based discussions.
The first questions for physicians are:
- Do I need this information?
- Why do I need it?
- Does it benefit the patient or the business?
- What is the best way to retain and access it now and in the future?”
Another key question is: What is necessary to improve patient care? That’s a decision both patient- and specialty-specific. It is also related to what is needed for the practice or system, since patient data is expected to be shared with referring physicians.
Further, the business focus must be considered. Is it worth continuing with the MIPS program? Are we gathering demographic and insurance information in a timely manner and reviewing it frequently enough? If staff is too busy doing unnecessary tasks, they are not supporting the patient process as effectively as they should.
Using the “5S” workplace organization methodology in all areas of “paperwork” can help tremendously. The idea is to reduce paperwork or clutter in the work area. Work areas include the exam rooms, nurses’ station, and the clinician office.
If you look around at any of these areas, there are items that distract your attention or get in the way of “finishing” your current task. Following the 5S will start and keep you on the path to an efficient work environment and facilitate the reduction of paperwork. The 5S model is:
- Sort: identify what is needed, eliminate everything else
- Set in order: determine where needed items go and when
- Shine: update the data, removing anything unnecessary
- Standardize: approacheach patient in the same fashion with the same data goals in the first three S’s
- Sustain: make all of this a habit