Improving EHR Usability by Reducing Regulatory Burdens

it is our experience that clinicians_ frustrations with EHRs are often less about the technology, and more about using it not simply for patient care but to fulfill regulation-driven dIn a speech last month, CMS Administrator Seema Verma expressed her desire for CMS “to focus on patients first.” To do this, she said, “one of our top priorities is to ease regulatory burden that is destroying the doctor-patient relationship. We want doctors to be able to deliver the best quality care to their patients.”

We applaud Administrator Verma for leading this effort to reduce regulatory burdens on healthcare providers. As regulatory requirements for data collection from clinicians directly through the EHR have increased, it has become increasingly more challenging to maintain focus on the data essential to direct patient care.

While EHRs are often mentioned as a prime culprit in news reports of physician burnout, it is our experience that clinicians’ frustrations with EHRs are often less about the technology, and more about using it not simply for patient care but to fulfill regulation-driven documentation requirements.

For example, EHR design has been affected as much by the requirements of the ONC certification program and other regulatory documentation requirements as by what our customers ask for, as acknowledged by ONC’s deputy assistant secretary for health technology reform, John Fleming, M.D., in a recent interview. “‘As we began to add Meaningful Use, it began to create problems,’ Fleming said. ‘It was creating additional workloads, and developers were turning their attention to meeting requirements from ONC rather than making me happy as a customer.’”

Of course, documentation burdens long preceded EHRs, and involved often-cumbersome paper processes that EHR use has streamlined.

Modern EHRs in exam rooms enable doctors and other clinicians to access and share information far more quickly and accurately. An EHR displays the most current patient data and the tools to review and filter this data, and can delve into other aspects of the patient’s chart; it allows clinicians to view notes from other caregivers and review alerts driven by clinical decision support features; and it can make the process of ordering tests and medications, and referring patients to specialists within the approved network, more efficient.  All of these EHR-aided activities support high quality, efficient patient care.

It does take training and a desire to have the tool serve the user rather than the other way around. We see countless examples of the former among our customers, and we’re committed to listening to EHR users and continually enhancing product usability.

In October, CMS Administrator Verma announced new initiatives to respond to healthcare industry concerns that providers are being overwhelmed by regulatory burdens.


  • Patients Over Paperwork is “a cross-cutting, collaborative process that evaluates and streamlines regulations with a goal to reduce unnecessary burden, increase efficiencies, and improve the beneficiary experience.”
  • Meaningful Measures “will involve only assessing those core issues that are most vital to providing high-quality care and improving patient outcomes. The agency aims to focus on outcome-based measures going forward, as opposed to trying to micromanage processes.”

“Patients first” should always be at the core of everything those of us in the healthcare industry do, and we look forward to learning more about and contributing our collective expertise to CMS’ “Patients Over Paperwork” and “Meaningful Measures” initiatives, as well as ONC’s activities to improve usability and interoperability of EHRs.

See our other recent blog posts to learn more about EHRA’s efforts to advance interoperability (we’ve collected examples that show it’s already having positive effects) and usability (understanding end-users is key).

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  1. HIMSS18: Listening, Learning, Leading | EHRA Blog
  2. Final IPPS Rule Ignores EHR Developer Concerns–Includes Impossible Measures, Will Lead to Increased Clinician Burden | EHRA Blog

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