It’s time for all those involved in the healthcare industry to reevaluate and reduce the administrative task burden placed on clinicians, according to policy recommendations from the American College of Physicians (ACP).
The position paper, published online in the Annals of Internal Medicine, offered a framework to free physicians from the daily churn of prior authorizations, computerized order entry, billing-related documentation — and the resulting risk for burnout:
- Non-clinicians who impose administrative tasks on physicians should have to “provide financial, time, and quality-of-care impact statements for public review and comment”
- Administrative tasks must be reviewed regularly to make sure they continue to make sense for the healthcare system, with those found redundant or unnecessary eliminated
- Professional societies, frontline clinicians, patients, and electronic health record vendors should collaborate “to aim for performance measures that minimize unnecessary clinician burden, maximize patient and family centeredness, and integrate the measurement of and reporting on performance with quality improvement and care delivery”
- Existing health information technology must be improved and innovative alternatives developed
- Research is needed on the effect of administrative tasks on healthcare system quality, time, and cost for providers and patients, and on best practices to help clinicians reduce administrative burden within their practices
The position paper was written by the ACP’s Shari M. Erickson, MPH, and colleagues on the group’s Medical Practice and Quality Committee.
Calling these recommendations “bold,” Christine A. Sinsky, MD, of the American Medical Association in Chicago, wrote in an accompanying editorial, “The medical community has come to expect evidence-based medical practice. A similar expectation for evidence-based policy, regulation, and information technology has not yet been established.”
“Such tasks as documenting pain levels, learning styles, advance directives, or fall risk may each require only a minute or two, so the time costs to an entity imposing such requirements may seem trivial,” Sinsky wrote. “Multiplied over the hundreds of daily tasks performed by physicians and their staff, however, these costs become substantial.”
“The ACP recommendations are a timely call for greater evidence-based regulation and for a shared responsibility to create better value in healthcare,” she concluded.
Sinsky even suggested another recommendation: consider carefully the value of physicians’ signatures.
“Does every hearing aid battery, cane, pair of diabetic shoes, mastectomy bra, ear wash, influenza vaccination, or lipid profile order need to pass through the physician’s inbox for a signature? To my knowledge, no evidence exists that such paperwork advances patient safety or quality,” she argued. “In fact, the opposite may be true.”