{"id":17386,"date":"2021-03-04T12:43:52","date_gmt":"2021-03-04T17:43:52","guid":{"rendered":"https:\/\/healthit-gov.go-vip.net\/buzz-blog\/?p=17386"},"modified":"2025-07-08T14:14:27","modified_gmt":"2025-07-08T14:14:27","slug":"reducing-the-clinician-burden-shaping-health-it-as-an-asset","status":"publish","type":"post","link":"https:\/\/healthit.gov\/blog\/insights-updates\/reducing-the-clinician-burden-shaping-health-it-as-an-asset\/","title":{"rendered":"Reducing the Clinician Burden: Shaping Health IT as an Asset"},"content":{"rendered":"\n<p><span data-contrast=\"auto\">Health IT has&nbsp;<\/span><span data-contrast=\"auto\">helped<\/span><span data-contrast=\"auto\">&nbsp;<\/span><span data-contrast=\"auto\">drive<\/span><span data-contrast=\"auto\">&nbsp;progress in<\/span><span data-contrast=\"auto\">&nbsp;<\/span><span data-contrast=\"auto\">health care&nbsp;<\/span><span data-contrast=\"auto\">over the last decade,&nbsp;<\/span><span data-contrast=\"auto\">but it has also introduced&nbsp;<\/span><span data-contrast=\"auto\">a variety of&nbsp;<\/span><span data-contrast=\"auto\">different challenges<\/span><span data-contrast=\"auto\">, many reported by the&nbsp;<\/span><span data-contrast=\"auto\">clinical community.&nbsp;<\/span><span data-contrast=\"auto\">As we explored in our&nbsp;<\/span><a href=\"https:\/\/academic.oup.com\/jamia\/advance-article\/doi\/10.1093\/jamia\/ocaa330\/6133902?guestAccessKey=c8c9f69e-4b5f-4feb-99a7-d90730cf479e\"><span data-contrast=\"auto\">latest article<\/span><\/a><span data-contrast=\"auto\">&nbsp;published in the Journal of the American Medical Informatics Association, ONC and other federal partners have taken and continue to take steps to reduce clinician burden when using health IT.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">&nbsp;<\/span><wp-block data-block=\"core\/more\"><\/wp-block><\/p>\n\n\n\n<p><span data-contrast=\"auto\">As adoption of health IT has increased, we have seen firsthand how usability issues<\/span><span data-contrast=\"auto\">&nbsp;associated with the underlying software<\/span><span data-contrast=\"auto\">,&nbsp;<\/span><span data-contrast=\"auto\">implementation choices made by practices and institutions,&nbsp;<\/span><span data-contrast=\"auto\">and&nbsp;<\/span><span data-contrast=\"auto\">lack of effective training can diminish the desired impact of health IT use<\/span><span data-contrast=\"auto\">.&nbsp;<\/span><span data-contrast=\"auto\">Well-meaning initiatives promoting field-defined, actionable data&nbsp;<\/span><span data-contrast=\"auto\">have led to \u201ccheck the box\u201d workflows and&nbsp;<\/span><span data-contrast=\"auto\">subsequent&nbsp;<\/span><span data-contrast=\"auto\">loss of the patient\u2019s narrative.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">Rectifying these issues requires coordinated attention to improved design of health IT systems, better system configuration decisions, and effective end-user training during implementation.&nbsp;<\/span><span data-contrast=\"auto\">T<\/span><span data-contrast=\"auto\">hese actions can help health IT to function as an asset instead of an obstacle, and positively impact usability, safety, clinician satisfaction with health IT<\/span><span data-contrast=\"auto\">, and care<\/span><span data-contrast=\"auto\">.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">&nbsp;<\/span><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-reducing-clinician-burden-nbsp\"><b><span data-contrast=\"auto\">Reducing Clinician Burden<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">&nbsp;<\/span><\/h2>\n\n\n\n<p><span data-contrast=\"auto\">In 2016<\/span><span data-contrast=\"auto\">, Congress enacted the&nbsp;<\/span><a href=\"https:\/\/healthit.gov\/information-blocking\/\/\"><span data-contrast=\"none\">21st Century Cures Act<\/span><\/a><span data-contrast=\"auto\">&nbsp;(Cures Act), which included requirements for the executive branch to examine and address clinician burden related to the use of electronic health records (EHRs). As a result, ONC&nbsp;<\/span><span data-contrast=\"auto\">engaged&nbsp;<\/span><span data-contrast=\"auto\">with the Centers for Medicare &amp; Medicaid Services (CMS) and other federal&nbsp;<\/span><span data-contrast=\"auto\">partners<\/span><span data-contrast=\"auto\">&nbsp;to understand and document clinician burden challenges.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">Based on<\/span><span data-contrast=\"auto\">&nbsp;these efforts,&nbsp;<\/span><span data-contrast=\"auto\">ONC released the&nbsp;<\/span><a href=\"https:\/\/healthit.gov\/\"><span data-contrast=\"none\">Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs<\/span><\/a><span data-contrast=\"auto\">. This report identifies four major areas of concern:<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">&nbsp;<\/span><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><span data-contrast=\"auto\">D<\/span><span data-contrast=\"auto\">ocumentation requirements for billing;<\/span><span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n\n\n\n<li><span data-contrast=\"auto\">Q<\/span><span data-contrast=\"auto\">uality reporting requirements;<\/span><span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n\n\n\n<li><span data-contrast=\"auto\">C<\/span><span data-contrast=\"auto\">onflicting federal and state regulations; and<\/span><span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n\n\n\n<li><span data-contrast=\"auto\">I<\/span><span data-contrast=\"auto\">ssues related to health IT, including usability<\/span><span data-contrast=\"auto\">.<\/span><span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ol>\n\n\n\n<p><span data-contrast=\"auto\">We found several key usability issues with current health IT system design and implementation including ineffective cognitive support for users, issues with interface design and integrating health IT into physical environments, limitations of current functionality such as order entry, and how configuration and implementation decisions could impact usability and use. In the report, we outline four areas that need to be addressed to improve the usability of health IT:<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">&nbsp;<\/span><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><span data-contrast=\"auto\">Better alignment of EHRs with clinical workflow, including improved decision making and documentation tools;<\/span><span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n\n\n\n<li><span data-contrast=\"auto\">Optimized user interface design to improve efficiency, experience, and end-user satisfaction;<\/span><span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n\n\n\n<li><span data-contrast=\"auto\">Harmonized clinical content to reduce burden; and<\/span><span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n\n\n\n<li><span data-contrast=\"auto\">Promotion of implementation decisions for clinician efficiency, satisfaction, and lower burden<\/span><span data-contrast=\"auto\">.<\/span><span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-where-we-go-from-here-nbsp\"><b><span data-contrast=\"auto\">Where We Go From Here<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">&nbsp;<\/span><\/h2>\n\n\n\n<p><span data-contrast=\"auto\">To<\/span><span data-contrast=\"auto\">&nbsp;keep advancing health IT,&nbsp;<\/span><span data-contrast=\"auto\">all of us across the health care system&nbsp;<\/span><span data-contrast=\"auto\">need to continue emphasizing user-centered design&nbsp;<\/span><span data-contrast=\"auto\">and&nbsp;<\/span><span data-contrast=\"auto\">human factors and ergonomics. As&nbsp;<\/span><a href=\"https:\/\/healthit.gov\/information-blocking\/\/\"><span data-contrast=\"none\">ONC<\/span><\/a><span data-contrast=\"auto\">&nbsp;and&nbsp;<\/span><a href=\"https:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/Interoperability\/index\"><span data-contrast=\"none\">CMS<\/span><\/a><span data-contrast=\"none\">\u2019<\/span><span data-contrast=\"auto\">&nbsp;<\/span><span data-contrast=\"auto\">&nbsp;<\/span><span data-contrast=\"auto\">recent&nbsp;<\/span><span data-contrast=\"auto\">rules&nbsp;<\/span><span data-contrast=\"auto\">are implemented, health IT developers should be designing systems with&nbsp;<\/span><span data-contrast=\"auto\">clinical<\/span><span data-contrast=\"auto\">,<\/span><span data-contrast=\"auto\">&nbsp;<\/span><span data-contrast=\"auto\">cognitive<\/span><span data-contrast=\"auto\">,<\/span><span data-contrast=\"auto\">&nbsp;and workflow needs&nbsp;<\/span><span data-contrast=\"auto\">in<\/span><span data-contrast=\"auto\">&nbsp;mind.&nbsp;<\/span><span data-contrast=\"auto\">Institution<\/span><span data-contrast=\"auto\">s should be making configuration decisions based on&nbsp;<\/span><span data-contrast=\"auto\">frontline clinical&nbsp;<\/span><span data-contrast=\"auto\">users\u2019 needs<\/span><span data-contrast=\"auto\">&nbsp;identified using established human factors and&nbsp;<\/span><span data-contrast=\"auto\">ergonomics methods<\/span><span data-contrast=\"auto\">.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">In the coming year<\/span><span data-contrast=\"auto\">s<\/span><span data-contrast=\"auto\">, ONC will&nbsp;<\/span><span data-contrast=\"auto\">continue<\/span><span data-contrast=\"auto\">&nbsp;to&nbsp;<\/span><span data-contrast=\"auto\">collaborate with our colleagues in the public and private sectors to&nbsp;<\/span><span data-contrast=\"auto\">address<\/span><span data-contrast=\"auto\">&nbsp;<\/span><span data-contrast=\"auto\">previously identified&nbsp;<\/span><span data-contrast=\"auto\">usability&nbsp;<\/span><span data-contrast=\"auto\">challenges<\/span><span data-contrast=\"auto\">.&nbsp;<\/span><span data-contrast=\"auto\">We will also continue to&nbsp;<\/span><span data-contrast=\"auto\">work<\/span><span data-contrast=\"auto\">&nbsp;<\/span><span data-contrast=\"auto\">with CMS and other federal partners to<\/span><span data-contrast=\"auto\">&nbsp;<\/span><span data-contrast=\"auto\">look for ways to<\/span><span data-contrast=\"auto\">&nbsp;reduce health IT-related documentation requirements that add to clinician burden.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">To learn more about the steps ONC has taken and continues to take to reduce the clinician burden, please refer to our latest Journal of the American Medical Informatics Association article,&nbsp;<\/span><a href=\"https:\/\/academic.oup.com\/jamia\/advance-article\/doi\/10.1093\/jamia\/ocaa330\/6133902?guestAccessKey=c8c9f69e-4b5f-4feb-99a7-d90730cf479e\"><span data-contrast=\"none\">HITECH to 21<\/span><span data-contrast=\"none\">st<\/span><span data-contrast=\"none\">&nbsp;Century Cures: Clinician Burden and Evolving Health IT Policy<\/span><\/a><span data-contrast=\"auto\">.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">&nbsp;<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Health IT has&nbsp;helped&nbsp;drive&nbsp;progress in&nbsp;health care&nbsp;over the last decade,&nbsp;but it has also introduced&nbsp;a variety of&nbsp;different challenges, [&hellip;]<\/p>\n","protected":false},"author":619,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_selected_menu":"","_show_breadcrumbs":"true","_blog_show_featured_image":false,"footnotes":""},"categories":[],"archived-category":[],"featured":[],"topics":[408,415,425,417],"class_list":["post-17386","post","type-post","status-publish","format-standard","hentry","topics-care-continuum","topics-clinical-quality-safety","topics-hit-policy","topics-usability-provider-burden"],"acf":{"blog_authors":[{"blog_author_profiles":"198645"},{"blog_author_profiles":"198667"}],"hp_news_hide":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.3 (Yoast SEO v24.8.1) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Reducing the Clinician Burden: Shaping Health IT as an Asset - ONC Blog<\/title>\n<meta name=\"description\" content=\"Explore how health IT progress and challenges are addressed by ONC, improving usability, care quality, and reducing clinician burden. 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