Why On Earth Are Physicians Still Collecting Patient Data Using Paper Forms?

As part of its “Patients over Paperwork” effort, CMS recently issued a Request for Information seeking new ideas on reducing levels of administrative burden.

The initiative seems to be making a serious impact. According to CMS, reforms identified by Patients over Paperwork since it launched in late 2017 should save roughly 40 million hours and $5.7 billion through 2021. This impact comes from changes such as streamlining documentation requirements and billing codes, changing the Medicare reimbursement model for skilled nursing facilities and adopting more meaningful areas for quality measurement and improvement.

That being said, CMS either isn’t considering or isn’t taking seriously an approach which could streamline virtually every patient’s experience and make it much simpler for providers to manage patient data. This magic trick is nothing more than making sure all data on patients is entered digitally the first time their provider collects it.

By this point in the evolution of digital healthcare, I should rarely if ever need to fill out paper forms for manual data entry by a clerk. Unfortunately, though, it happens all of the time.

Before you warn me that creating a universal method for patient data collection isn’t easy, let’s assume I get it. I’m sure that care providers would love to avoid the extra time and inevitable errors generated by this process. I’m also confident that they know many patients loathe filling out forms. (I certainly make that point whenever I have the chance.)

On the other hand, I don’t get the sense that my local medical groups see digital patient data collection as a priority, either. I’ve asked countless doctors and nurses whether they think their institution will switch to 100% digital patient forms anytime soon, and nobody sees it happening in the foreseeable future.

The truth is, while it may not be exactly a trivial exercise, having patients fill out pre-visit forms using a PC workstation, app or tablet doesn’t call for an extraordinary effort either. Technical challenges aren’t the big bottleneck here; administrative policy and resistance to change are.

We won’t see too much more change in this arena until medical practices identify a reason to come on board enthusiastically, though. While many hospital CIOs are beginning to see an all-digital process as critical to their survival, I don’t think medical practice leaders see things the same way.

Yes, physician practices are making some progress towards digital-first transactions, notably when it comes to enabling patients to make web-, app- and portal-based payments. After all, patients can pay for virtually everything else digitally, so things could get a bit ugly if they didn’t.

On the other hand, it seems that practices still haven’t streamlined even this necessary digital relationship. According to a recent survey by payments vendor InstaMed, 90% of practices responding said they use paper and manual processes in their collections efforts, and 77% said it took more than a month for them to collect any payments at all. Given how long this evolution is taking, it’s no surprise that many groups are still mired in manual data collection.

It’s not hard to argue that if we get medical groups to collect patient data only once, it could reduce administrative burden, improve the accuracy of patient data and save many, many hours of clerical effort. Why aren’t we pushing this harder?

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.


  • Hi Anne,

    Great article. Sorry that this: “Why aren’t we pushing this harder?” remains a challenge and a bit of a mystery. Doctors who are at their prime in practice today – graduated before the Netscape browser and the Internet existed. The medical profession – has not bought into the concept of medical knowledge management and digital tools as an essential element of the practice of medicine. The resistance to change (as you noted) is profound – IMHO in part due to the ‘Guild of Medicine”. It may sound a bit esoteric or even political – but change is not built into the process of educating students or the lifelong learning required to remain competent in practice.

    The best example today of the complete abrogation of knowledge management and digital tools are the EMRs in place today – now over 1/2 of the time of a patient visit – is spent by clinicians (now data entry clerks) on a computer terminal or tablet. Just FYI if you want to read more: https://www.linkedin.com/pulse/why-digital-health-still-pitiful-part-ii-krucik-bsc-cs-md-mba/

    Thanks again for the article.
    Best regards,

  • Hi Anne:

    The obvious question is who pays. In my 30 years practice I’ve gone from paper charts to countless EMRs. I have passwords to at least a dozen for everywhere I work. None talk. It’s a mess.
    Ideally someone like google needs to centralize health care data collection and have the EMRs import it. That’s not a physician issue- it’s a legislative and IT issue. Centralized data with handshaking was supposed to happen but did not.
    I run a solo practice. I’m techy. My patients are aged 60-80. They don’t like computer screens. I don’t want to spend more money and time on waiting room tech.

    Give me centralized healthcare repositories and seamless EMR handshaking. Oh, and don’t make me, the physician, pay for it.

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