While medical schools require future physicians to start learning the ins and outs of electronic health records (EHRs) during their training, federal guidelines are standing in the way of true progress in their learning.
Currently, the U.S. Centers for Medicare & Medicaid Services (CMS) guidelines prohibit medical students from being considered legal billing providers for patient care. One of the results of the rule at the medical practice and hospital level is a disincentive for teaching physicians to encourage student EHR documentation for fear of a compliance violation. Add in additional fears of a possible confidentiality issues under the Health Insurance Portability and Accountability Act (HIPAA) and technical complexities with multiple systems and logins and students are essentially being blocked from hands-on EHR knowledge.
“It stymies not only the student’s education, but it also stymies good patient care,” said David R. Donnersberger, MD, JD, an internist and clinical assistant professor of medicine at the University of Chicago’s Pritzker School of Medicine.
Donnersberger was part of a panel outlining the conflict at this year’s American College of Physicians (ACP) 2016 Internal Medicine Meeting in Washington D.C. In his work with students, Donnersberger noted that no one spends more time bedside with the patient than med students and their information is valuable, but their inability to make that knowledge part of the chart – unless re-entered by the physician – is a true disservice, he said.
Further reading: EHRs are ruining the physician-patient relationship
So while the American Association of Medical Colleges, for example, stipulates that medical students need to have hands-on experience, including entering and retrieving information in a medical record, CMS states clearly several billable elements of a patient encounter can only be documented by the doctor and not a student.