In a March 7 session presented at HIMSS18 in Orlando, Shari Erickson, MPH, vice president of government affairs and medical practice at the American College of Physicians (ACP), discussed how healthcare organizations can reduce administrative tasks to reduce physician burnout.
Electronic health records (EHRs) are designed to streamline workflows, but increased administrative tasks has increased stress and burnout. In this session, Erickson explained the impact of administrative tasks and how organizations can reduce their impact.
Administrative tasks impact billing and insurance-related activities, patient care and physician satisfaction. In billing and insurance, ACP found that for every hour spent with patients, at least two hours are spent doing EHR or other desk work. In patient care, according to a 2013 nation survey, 73 percent of residents said care was compromised due to increasing documentation requirements. Another study found hospitalists spent more time reviewing and documenting EHRs than interacting with patients.
To addresses burnout, Erickson said ACP developed the “Patient Before Paperwork” initiative in 2015, which included four steps:
- Identify and prioritize which complexities are of the top concern for ACP members and patients.
- Educate ACP members, other physicians and policy makers on what makes up administrative complexities, including the intent of the requirement and how the complexity impact patients and physicians.
- Implement the most effective advocacy, stakeholder engagement and practice support approaches to help mitigate or eliminate the top priority complexities.
- Reduce physician burnout, help restore the joy of practice and reinvigorate the patient-physician relationship.
To achieve these steps, ACP turned to policy solutions to reduce administrative tasks leading to physician burnout. These policy recommendations included:
- Stakeholders who develop or implement administrative tasks should impact statements for public review and comment.
- Tasks that cannot be eliminated must be regularly reviewed, revised, aligned and/or streamlined with the goal of reducing burden
- Stakeholders should collaborate to aim for performance measures that minimize unnecessary burden and integrate measurement of and reporting on performance with quality improvement and care delivery.
- Stakeholders should collaborate in making better use of existing health IT, as well as developing more innovative approaches.
- As U.S. healthcare systems evolve to focus on value, stakeholders should review and consider streamlining or eliminating duplicative administrative tasks.
- Rigorous research is needed on the impact of administrative tasks on our health care system.
- Research on and dissemination of evidence-based best practices to help physicians reduce administrative burden within their practices and organizations.