Task force says simplified documentation, transparency could improve EHRs

A multidisciplinary task force put together by the American Medical Informatics Association (AMIA) shared its recommendations for improving electronic health records (EHRs) in the Journal of the American Medical Informatics Association.

The AMIA EHR 2020 Task Force revealed a total of 10 recommendations, breaking them down into five specific categories: “Simplify and speed documentation,” “refocus regulations,” “increase transparency and streamline certification,” “foster innovation,” and “the EHR in 2020 must support person-centered care delivery.”

“Much of the focus of the last decade, via MU and other incentives, was to encourage providers and other health professionals to implement EHRs and use them to capture and share data important to quality and cost,” Thomas H. Payne, MD, and the rest of the task force wrote. “The work now ahead is to ensure that these systems are designed and implemented in a way that yields promised benefits to efficiency, quality and safety with fewer side effects. While cost, usability, and other considerations are important, patient safety and quality of care need to guide how we optimize these systems.”

Some of the task force’s recommendations focused on lessening the burden on physicians to input data. One result of the implementation of EHRs and the continued lack of true interoperability between them has been having a negative impact on physician morale, the group wrote.

“These frustrations are contributing to a decreased satisfaction with professional work life,” the task force wrote. “In professional journals, press reports, on wards and in clinics, we have heard of the difficulties that the transition to EHRs has created. Clinicians ask for help getting through their days, which often extend into evenings devoted to writing notes.”

The task force suggests that other members of the care team, or even the patients themselves, could help with entering data. In addition, that data could then be used to generate customized reports, saving physicians additional time.

Make compliance simpler

Another change recommended by the task force is to simplify the certification process. After working so hard to meet meaningful use (MU) stage 1 requirements, for example, providers and hospitals have to immediately begin looking ahead to the next stages, and this takes focus away from true innovation.

Regulation should also be updated, the task force writes, through improved interoperability and a reduction in the total amount of required data entry.

“Data collected should only include those necessary to diagnose and treat the patient’s condition and not add to the documentation burden,” the task force wrote.

Increased transparency is another primary focus of the recommendations. The task force believes more data should be made available about the certification process, and risks that exist as a result of EHRs should be highlighted.

“There is much evidence that health information technology can improve patient safety, but there is also evidence that these systems can introduce safety risks and other unintended consequences, such as wrong patient errors, copy and paste errors, and alert fatigue,” the task force writes.

The task force also recommended changes to the interfaces of these EHRs. By using standards-based application programming interfaces (APIs), for example, they would be easier to access across the board.