AHA calls on CMS to reduce clinical documentation burden

The American Hospital Association contends that the Centers for Medicare and Medicaid Services has not done enough to cut the documentation burdens that clinicians face.

AHA sent a letter to CMS on Wednesday with a number of policy recommendations that the hospital group believes the agency should include in its proposed rule for the Calendar Year 2020 physician fee schedule.

“The time spent documenting patient visits is time that providers cannot spend in face-to-face interaction with patients—negatively impacting patient care and provider well-being,” wrote AHA Executive Vice President Thomas Nickels to CMS Administrator Seema Verma.

“The patterns of EHR use that result from current documentation requirements are putting providers and patients at risk for real harm,” added Nickels. “We strongly encourage CMS to explore ways to return the medical record to a tool that captures patients’ dynamic narratives and supports communication between providers.”

While Nickels commended Verma for beginning to make these changes in the CY 2019 physician fee schedule final rule, he made the case that more needs to be done by CMS to make these changes meaningful.

Also See: Seema Verma tells docs CMS will reduce EHR documentation burdens

Among other recommendations, AHA urged CMS to:

· Return the medical record to the dynamic patient narrative it was designed to be and a tool that supports provider-to-provider interaction.

· Improve the accuracy and usability of medication lists.

· Improve the security, portability and management of patient data by testing the usability of blockchain.

“Providers must spend hours repeatedly sorting through patients’ medications and prescriptions, and inputting that information into medical records, only to have the next provider repeat the task,” according to Nickels. “A more ideal system would utilize cloud-based computing to enable real-time input and updating of medication lists, including the medications that the patient has been prescribed and those he or she actually fills and takes.”

Toward that end, AHA strongly urged CMS to “put in place incentives to encourage or require vendors to improve EHRs” and for the agency to use its “authority under the Center for Medicare and Medicaid Innovation (CMMI) to conduct a demonstration to test shifting authority for medication lists to pharmacists.”

When it comes to blockchain, Nickels argued that the technology “would enable all users of a medical record to see real-time, synced updates, producing a medical record that contains a patient’s entire medical history and that is always up-to-date.”

As a result, AHA wants CMS to “use its CMMI authority to test the use of blockchain technology to address some of the factors that contribute to providers’ documentation burden, which could be accomplished by including it as an aspect of other demonstrations.”