AMA: EHR documentation "pure torment"

Providers and other industry stakeholders took advantage of a listening session held by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT on May 3, that focused on electronic health record systems and billing, to express their frustration with allegations that they're using such tools to commit billing fraud.     

Sue Bowman, senior director of coding policy and compliance for the American Health Information Management Association, called for more research on the higher levels of coding and reimbursement with EHRs, noting in testimony that "the extent to which EHRs have led to improper reimbursement is unclear." Benjamin Chu, M.D., chair of the American Hospital Association, who also was invited to speak at the session, acknowledged the "funny tension" between EHRs and coding, and despite the seeming higher reimbursement, was "convinced the cost of care will come down" with increased use of EHRs.

Steven Stack, Chair of the American Medical Association's Board of Trustees, used the forum as an opportunity to vent a number of frustrations, including the "pure torment" of EHR documentation and physician dissatisfaction with EHRs and the Meaningful Use program. He noted that use of EHR tools such as cutting and pasting are meant to address the inefficiencies of EHRs, and called having to re-engineer unnecessary variation into notes in order to get paid an "appalling Catch-22." 

Jonathan Blum, Deputy Administrator and Director for CMS' Center for Medicare, acknowledged that while the government is committed to EHRs, it has to be "mindful" of the unintended consequences of enhanced billing by EHR users, adding that EHRs can't "undermine" other policy goals.

The government has expressed concern about the misuse of EHRs leading to billing fraud. The Office of Inspector General has included this issue in its 2013 work plan, and at least one Medicare contractor won't pay claims containing cloned notes.

To learn more:
- access the session materials
- here's AHIMA's testimony (.pdf)
- read AMA's testimony (.pdf)