Widespread implementation of EHRs has left the majority of physicians spending more time at a keyboard than with patients. A massive shift toward paying for value over volume could relieve that burden.
Physicians are stuck in “EHR purgatory,” writes Allan H. Goroll, M.D., an internal medicine physician at Massachusetts General Hospital (MGH) in Boston, in a perspective for the New England Journal of Medicine. Although physician practices and hospitals have turned to several short-term solutions—including voice-recognition software and medical scribes—Goroll argues that a significant shift toward value-based payments will force EHRs to evolve to a more patient-centered tool.
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“Clinician entries could be complemented by a patient-generated functional status report and set of personal care goals,” he wrote. “Such an EHR would begin to take on the look and feel of an essential instrument of patient care and population health management rather than a billing statement.”
A recent study showed physicians split their time evenly between a computer and their patient, while other research has shown that doctors get three times more face time with computers than patients. Some have urged EHR vendors to consult with more doctors to fix the burdensome flaws associated with EHRs.
Department of Health and Human Services Secretary Tom Price has said the agency needs to focus its efforts on making EHRs less burdensome for physicians by forcing the government to take a backseat when it comes to regulations. Under Trump’s budget, the Office of the National Coordinator for Health IT would shift much of its focus to reducing EHR burdens.
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Goroll points to accountable care organizations that have successfully implemented risk-based payment models along with isolated provider-payer collaborations that emphasize value. But he admits that broad reforms are “likely to trigger considerable discomfort and resistance” since hospitals and physician practices have invested significant time and money into the current EHR systems.