ACP Offers Recommendations On Reducing MD Administrative Overload

As everyone knows, physicians are being overwhelmed by outsized levels of administrative chores. As if dealing with insurance companies wasn’t challenging enough, in recent years EMRs have added to this burden, with clinicians doing double duty as data entry clerks after they’re seen patients.

Unfortunately, streamlining EMR use for clinical use has proven to be a major challenge. Still, there are steps healthcare organizations can take to cut down on clinicians’ administrative frustrations, according to the American College of Physicians.

The ACP’s recommendations include the following:

  1. Stakeholders responsible for imposing administrative tasks – such as payors, government and vendors – should analyze the impact of administrative tasks on physicians. If a task is found to have a negative effect on care quality, needlessly questions a clinician’s judgment or increases costs, it should be challenged, fixed or removed.
  2. If an administrative task can’t be cut, it must be reviewed, revised, aligned or streamlined to reduce stakeholders’ burden.
  3. Stakeholders should collaborate with professional societies, clinicians, patients and EMR vendors to develop performance measures that minimize needless clinician burden and integrate performance reporting and quality improvement.
  4. All key stakeholders should collaborate in reducing, streamlining, reducing and aligning clinicians’ administrative tasks by making better use of health IT.
  5. As the US healthcare system shifts to value-based payment, stakeholders should consider streamlining or eliminating duplicative administrative demands.
  6. The ACP would like to see rigorous research done on the impact of administrative tasks on healthcare quality, time and cost; on clinicians, staff and healthcare organizations; patient and family; and patient outcomes.
  7. The ACP calls for research on best practices for cutting down on clinicians’ administrative tasks within both practices and organizations. All key stakeholders, including clinician societies, payors, regulators, vendors and suppliers, should disseminate these evidence-based best practices.

It appears that even the federal government has begun to take these issues to heart. According to Modern Healthcare, late last year CMS announced a long-term initiative intended to reduce physicians’ administrative burdens.  Then-acting CMS Administrator Andy Slavitt said the initiative would hopefully make it a bit easier for practices to meet the requirements of the Quality Payment Program under MACRA.

But other sources of administrative frustration are likely to linger for the foreseeable future, as they’re deeply ingrained in stakeholder business processes or simply difficult to change.

For example, the American Academy of Family Physicians notes that some of the biggest aggravations and time wasters for its members include the need to get prior authorizations from health plans and outdated CMS documentation guidelines for E/M services which don’t leverage EMR capabilities. Sadly, I wouldn’t hold my breath waiting for either of those problems to be solved.

Still, it seems some healthcare organizations want to take on the administrative overhead problem. The University of Pittsburgh Medical Center has launched an initiative aimed at reducing the number of computer-related tasks doctors have to perform. According to the Pittsburgh Post-Gazette, UPMC is partnering with Microsoft to minimize physicians’ need to do electronic paperwork. Executives with the two organizations say this effort should result in tools for both doctors and patients.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

1 Comment

  • This is one area front line MDs could help more than “professional societies”.
    Where do we being? If CMS does not have a “level of care” order signed prior to discharge, the entire hospital stay is clawed back. If you do not “document” that you tried PT prior to a total hip replacement (btw never been shown to do anything) even a year AFTER the procedure is performed and paid for, it can be clawed back by recovery audits. Yep they look for buzzwords in the documentation. Do you really think as an ortho surgeon, I do not know when a patient needs a total hip? Please. If we do not use specific words in ordering Home health, it gets denied. If we do not put in a “date” last we had face to face time, it gets denied. Soon, the Amer Coll of Radiology wants us to use some RIDICULOUS clicky nightmare to get a “number” for an advanced imaging. You REALLY think as a Board Certified Ortho that I do not know when to order an MRI of a knee? Yes the RADIOLOGIST does not get paid if we do not get the number, but the RADIOLOGIST does not want to actually go see the patient to confirm the need for the test, they want the front line MD to do all the clicking. Awful. How about the E&M coding calculation ridiculousness? Has ANY of the mindless MU PQRS clicking done ANYTHING to improve care, efficiency, outcomes, safety, security? No way. So lets double down with MACRA. And add CPIA. Preauthorizations are out of control. Some fool in a booth is deciding care for a patient without actually seeing them, caring for them. Just the other day a peer to peer was requested and they gave us a 5 minute window to call them back. Yes. Call between 3 and 3:05pm or else. Maybe we should just have the preauth people take care of the patients. Not a day goes by that someone else wants to add MORE clicks and hassles to the front line physicians day. The crisis is already here. But for sure, this will be ignored until it breaks and then everyone is going to freak out that there are no MDs left. Its coming.

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