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The HL7 Reducing Clinician Burden Work Group (RCB WG) is an activity of the HL7 Electronic Health Record Work Group (EHR WG).
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The Reducing Clinician Burden (RCB) Project is an activity of the HL7 Electronic Health Record Work Group (EHR WG).
  
 
Please subscribe to the HL7 EHR WG listserver for meeting announcements, agendas and updates regarding current work.
 
Please subscribe to the HL7 EHR WG listserver for meeting announcements, agendas and updates regarding current work.
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The RCB Project team meets via teleconference on the 1st and 3rd Mondays each month - at 3PM ET (US).  To join the teleconference:  https://global.gotomeeting.com/meeting/join/798931918
  
 
NOTE:  DRAFT documents may be incomplete and are posted for Team review and discourse.  Please take care to note their draft (tentative) status if referencing or sharing with others.
 
NOTE:  DRAFT documents may be incomplete and are posted for Team review and discourse.  Please take care to note their draft (tentative) status if referencing or sharing with others.
  
  
==Reducing Clinician Burden Project==
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==HL7 RCB Project - Presentations==
Project team meets via teleconference on the 1st and 3rd Mondays each month - at 3PM ET (US).  To join the teleconference:  https://global.gotomeeting.com/meeting/join/798931918
 
  
*[[media:Reducing_Clinician_Burden-Overview-20190304.pdf|DRAFT Reducing Clinician Burden Project Overview, dated 4 Mar 2019]]
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*[[media:Reducing_Clinician_Burden-Overview-20190918.pdf|DRAFT Reducing Clinician Burden Project Overview, dated 18 Sep 2019]]
*[[media:Reducing_Clinician_Burden_Analysis_Worksheet-20190304.xlsx|DRAFT Reducing Clinician Burden Analysis Worksheet, DRAFT IN PROGRESS - COMMENTS ARE WELCOME!!, dated 4 Mar 2019]]
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*[[media:Schlossman_AMDIS_RCB_Presentation_final.pdf|Reducing Clinician Burden Project - New Directions in Alleviating Clinical Workflow and Documentation Burdens - Association of Medical Directors of Information Systems (AMDIS) Presentation, David Schlossman MD, presented 20 Jun 2019]]
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*[[media:HL7_EHR_S_and_Usability_DS_20190617.pdf|Update on HL7 EHR System Usability Functional Profile Project, HL7 Da Vinci Project, CMS Patients over Paperwork RFI, David Schlossman MD, presented 17 Jun 2019]]
  
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==HL7 RCB Project - Analysis Worksheet==
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*[[media:Reducing_Clinician_Burden_Analysis_Worksheet-201908019.xlsx|DRAFT Reducing Clinician Burden Analysis Worksheet, DRAFT IN PROGRESS - COMMENTS ARE WELCOME!!, dated 19 Aug 2019]]
  
 
=="See What We Mean"==
 
=="See What We Mean"==
 
*[https://ehrseewhatwemean.org/ "See What We Mean" Video Clips, developed by Medstar Health - National Center for Human Factors in Healthcare - EHR Safety and Usability Team]
 
*[https://ehrseewhatwemean.org/ "See What We Mean" Video Clips, developed by Medstar Health - National Center for Human Factors in Healthcare - EHR Safety and Usability Team]
  
 
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==HL7 RCB Project - Reducing Burden and Addressing Burnout - Success Stories==
==HL7 RCB Project - Reducing Burden - Success Stories==
 
 
*[[media:Reducing_Clinician_Burden-Success_Story_Template-20190128.docx|DRAFT Reducing Clinician Burden - Success Story Template, updated 28 Jan 2019]]
 
*[[media:Reducing_Clinician_Burden-Success_Story_Template-20190128.docx|DRAFT Reducing Clinician Burden - Success Story Template, updated 28 Jan 2019]]
*[[media:RCB_Story_-_Duke_Heart_Procedures.docx|Duke Heart Business Unit – Procedure Reporting, James Tcheng MD, posted 4 Feb 2019]]
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*[[media:RCB_Story_-_Duke_Heart_Procedures.docx|Duke University - Duke Heart Business Unit – Procedure Reporting, James Tcheng MD, posted 4 Feb 2019]]
 
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*[[media:Greta_Branford-UMich-HIMSS_2019.pdf|University of Michigan - Burnout: How EHR Usability Improves Efficiency & Satisfaction, Greta Branford MD, presented 14 Feb 2019 (Posted with Permission)]]
 
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*[[media:Monica_Jones-SNOMED_Clinical_Forum-20190409a.pdf|National Health Service - Rotherham Foundation Trust (UK) - Benefits of SNOMED CT from a clinical perspective, The Rotherham experience, Monica Jones, presented 9 Apr 2019 (Posted with Permission)]]
==US Office of National Coordinator for Health Information Technology (ONC) "Reducing Burden" Proposal and Draft for Comment==
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*[[media:HL7_-_CCA_Optimization_Presentation_7.15.19.pdf|University of Pennsylvania - Getting Time Back in Your Day!  Implementing a Multi-Faceted Approach to Optimizing Epic in the Ambulatory Setting, Jeff Tokazewski MD, Carole Rosen, Shane Thomas, 15 Jul 2019 (Posted with Permission)]]
*[https://www.healthit.gov/topic/usability-and-provider-burden/strategy-reducing-burden-relating-use-health-it-and-ehrs ONC DRAFT "Strategy on Reducing Burden Relating to the Use of Health IT and EHRs", including Findings, Strategies and Recommendations, published 28 Nov 2018, comment period closed 28 Jan 2019]
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*[[media:AHA-well-being-playbook.pdf|American Hospital Association - Well-Being Playbook, A Guide for Hospital and Health System Leaders, May 2019]]
*[[media:HL7_Response_Letter_ONC_Reducing_Burden_Strategy_FINAL.docx|HL7 Comments on ONC Draft Strategy, compiled by HL7 Policy Advisory Committee, submitted 28 Jan 2019]]
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*[[media:AHA-HL7_Burnout_Webinar-Arespacochaga-20190818.pdf|American Hospital Association - Well-Being Playbook Presentation, Elisa Arespacochaga, 19 Aug 2019]]
*[[media:CentriHealth-Comments_on_ONC_DRAFT_Burden_Reduction_Strategy.pdf|CentriHealth (UnitedHealth Group) Comments on ONC Draft Strategy, submitted 28 Jan 2019]]
 
  
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==HL7 RCB Project - Survey and Responses==
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*[[media:Reducing_Clinician_Burden-Survey_Responses-20190819.docx|RCB Project Survey and Responses, dated 19 Aug 2019]]
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*[[media:ACS-CMS_Mango_v3.0-Opelka-201906.pdf|"The Value Expression" Presentation to CMS, Frank Opelka MD, Medical Director, American College of Surgeons, Quality and Health Policy, published Jun 2019]]
  
 
==HL7 RCB Project - Focus Team Drafts==
 
==HL7 RCB Project - Focus Team Drafts==
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*[[media:Schlossman_HL7_RCB_Project_Focus_Teams_Report_20190508.pdf|DRAFT Reducing Clinician Burden - New Approaches to Clinical Workflow, Clinical Documentation, and Electronic Health Record Usability, Clinical Workflow and Documentation Focus Team Report, David Schlossman MD, Lisa Masson MD, Leads, updated 8 May 2019]]
 
*[https://drive.google.com/drive/folders/113pFh5kjX-dLR2K8jLlG-FJkLm-_5IN4?ogsrc=32 DRAFT Team Report - Clinical Documentation: Quality and Usability - Lisa Masson MD, Lead, updated 7 Jan 2019]
 
*[https://drive.google.com/drive/folders/113pFh5kjX-dLR2K8jLlG-FJkLm-_5IN4?ogsrc=32 DRAFT Team Report - Clinical Documentation: Quality and Usability - Lisa Masson MD, Lead, updated 7 Jan 2019]
 
*[[media:EHR_based_cognitive_support_to_Enhance_the_clinician_experience.pdf|DRAFT Team Outline - Clinical decision support, medical logic, artificial intelligence + Alerts, reminders, notifications, inbox management + Information overload - Jim McClay MD, Lead, updated 17 Jan 2019]]
 
*[[media:EHR_based_cognitive_support_to_Enhance_the_clinician_experience.pdf|DRAFT Team Outline - Clinical decision support, medical logic, artificial intelligence + Alerts, reminders, notifications, inbox management + Information overload - Jim McClay MD, Lead, updated 17 Jan 2019]]
 
*[[media:Reducing_Clinician_Burden_Project--Clinical_Workflow_and_Usability_Focus_Group_Report.docx|DRAFT Team Report - Clinical Workflow (Usability Focus) - David Schlossman MD, Lead, updated 21 Jan 2019]]
 
*[[media:Reducing_Clinician_Burden_Project--Clinical_Workflow_and_Usability_Focus_Group_Report.docx|DRAFT Team Report - Clinical Workflow (Usability Focus) - David Schlossman MD, Lead, updated 21 Jan 2019]]
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*[[media:Schlossman_HL7_RCB_Presentation_18MAR2019.pdf|DRAFT Root Cause Analysis - Clinical Workflow - David Schlossman MD, Lead, updated 18 Mar 2019]]
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*[[media:Legal_Burdens_Related_to_EHR's-Initial_Outline-BN-Draft-04012019.docx|DRAFT Team Outline - Legal aspects and risks - Barry Newman MD, updated 1 April 2019]]
 
*[[media:Physician_Burden_Issue.docx|DRAFT Team Report - Lock-In, Data Liquidity and Switching Costs - Michael Brody DPM, Lead, updated 15 Dec 2018]]
 
*[[media:Physician_Burden_Issue.docx|DRAFT Team Report - Lock-In, Data Liquidity and Switching Costs - Michael Brody DPM, Lead, updated 15 Dec 2018]]
 
*[[media:Data_Quality_interest_group_report_for_March_4_RCB_Meeting.docx|DRAFT Team Report - Data Quality - Reed Gelzer MD, Lead, updated 4 Mar 2019]]
 
*[[media:Data_Quality_interest_group_report_for_March_4_RCB_Meeting.docx|DRAFT Team Report - Data Quality - Reed Gelzer MD, Lead, updated 4 Mar 2019]]
  
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==US Office of National Coordinator for Health Information Technology (ONC) DRAFT "Strategy on Reducing Burden"==
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*[https://www.healthit.gov/topic/usability-and-provider-burden/strategy-reducing-burden-relating-use-health-it-and-ehrs ONC DRAFT "Strategy on Reducing Burden Relating to the Use of Health IT and EHRs", including Findings, Strategies and Recommendations, published 28 Nov 2018, comment period closed 28 Jan 2019]
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*[https://healthit.gov/burdencomments Summary of Public Comments for Draft Strategy, published 26 Mar 2019]
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*[[media:HL7_Response_Letter_ONC_Reducing_Burden_Strategy_FINAL.docx|HL7 Comments on ONC Draft Strategy, compiled by HL7 Policy Advisory Committee, submitted 28 Jan 2019]]
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*[[media:CentriHealth-Comments_on_ONC_DRAFT_Burden_Reduction_Strategy.pdf|CentriHealth (UnitedHealth Group) Comments on ONC Draft Strategy, submitted 28 Jan 2019]]
  
 
==HL7 RCB Project - Reference Sources==
 
==HL7 RCB Project - Reference Sources==
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*[https://jamanetwork.com/journals/jama/fullarticle/2738366 Journal of the American Medical Association - Redefining the Physician’s Role in Cost-Conscious Care - The Potential Role of the Electronic Health Record, Brian J Miller MD MBA MPH, Jennifer M Slota, Jesse M Ehrenfeld MD MPH, published 15 July 2019]
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*[https://www.hcinnovationgroup.com/clinical-it/physician-burnout/news/21088142/burnout-is-prevalent-but-clinicians-believe-health-systems-dont-properly-address-it Healthcare Innovation - Burnout is Prevalent, but Clinicians Believe Health Systems Don’t Properly Address It, Rajiv Leventhal, published 11 July 2019]
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*[https://www.healthcaredive.com/news/ehr-messaging-workflow-can-be-redesigned-to-address-burnout-study-suggest/557987/ Healthcare Dive - EHR messaging, workflow can be redesigned to address burnout, Ron Shinkman, published 1 July 2019]
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*[https://www.spok.com/clinicianburnout Spok - Clinician Burnout in Healthcare: A Report for Healthcare Leaders, published Jul 2019]
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*[https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05509 Health Affairs - Physicians’ Well-Being Linked To In-Basket Messages Generated By Algorithms In Electronic Health Records, Ming Tai-Seale, Ellis C Dillon, Yan Yang, Robert Nordgren, Ruth L Steinberg, Teresa Nauenberg, Tim C Lee, Amy Meehan, Jinnan Li, Albert Solomon Chan, and Dominick L Frosch, published Jul 2019]
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*[https://www.healthdatamanagement.com/opinion/why-the-movement-toward-a-patient-identifier-is-only-a-start?utm_campaign=second%20opinions-jun%2017%202019&utm_medium=email&utm_source=newsletter Health Data Management - Why the movement toward a patient identifier is only a start, Dan Cidon, published 17 Jun 2019]
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*[https://www.healthdatamanagement.com/opinion/why-ehrs-are-flawed-and-how-they-can-be-fixed?utm_campaign=second%20opinions-jun%2013%202019&utm_medium=email&utm_source=newsletter Health Data Management - Why EHRs are flawed, and how they can be fixed, David Lareau, published 13 Jun 2019]
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*[https://www.hcinnovationgroup.com/clinical-it/electronic-health-record-electronic-medical-record-ehr-emr/article/21083058/what-can-healthcare-it-leaders-do-to-flip-the-script-on-physician-burnout Healthcare Innovation - What Can Healthcare IT Leaders Do To Flip the Script on Physician Burnout?, Mark Hagland, published 3 Jun 2019]
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*[https://www.beckershospitalreview.com/ehrs/nearly-half-of-physicians-think-ehrs-have-decreased-quality-of-care-survey-finds.html?origin=qualitye&utm_source=qualitye Becker's Healthcare - Nearly half of physicians think EHRs have decreased quality of care, survey finds, Jackie Drees, published 1 May 2019]
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*[https://searchhealthit.techtarget.com/feature/Physician-burnout-eased-with-homegrown-tech TechTarget - Kaiser Permanente - Physician burnout eased with homegrown tech, Makenzie Holland, published 24 April 2019]
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*[https://academic.oup.com/jamia/advance-article/doi/10.1093/jamia/ocz021/5426085 Journal of the American Medical Informatics Association - The complex case of EHRs: examining the factors impacting the EHR user experience, Michael A Tutty, Lindsey E Carlasare, Stacy Lloyd, Christine A Sinsky, published 2 April 2019]
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*[https://www.healthaffairs.org/do/10.1377/hblog20190320.244258/full/?utm_source=Newsletter&utm_medium=email&utm_content=Reforming+Observation+Hospital+Care%3B+Price+Transparency%3B+CMS+Report+On+Risk+Adjustment%3B+Medicaid+Programs+That+Incentivize+Health-Promoting+Behaviors&utm_campaign=HAT+3-25-19 Health Affairs - What The Inspector General Gets Wrong About Reforming Observation Hospital Care, Ann M Sheehy,  Charles F S Locke, Bradley Flansbaum, published 25 Mar 2019]
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*[http://fortune.com/longform/medical-records/ Fortune and Kaiser Health News - Death by a Thousand Clicks: Where Electronic Health Records Went Wrong, Erika Fry and Fred Schulte, published 18 Mar 2019]
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*[https://www.kff.org/other/poll-finding/data-note-publics-experiences-with-electronic-health-records/?utm_campaign=KFF-2019-The-Latest&utm_source=hs_email&utm_medium=email&utm_content=70975474&_hsenc=p2ANqtz-_zM5rU_7EC28KiimXl3-En6Q0qCLLCuTKU4nBEtMlhaffCojvfzfDF1cSv_ZS-AJ2NEkgOAnzf8Tso_yGxoIUrXEf99w&_hsmi=70975474 Henry J Kaiser Family Foundation - Public’s Experiences With Electronic Health Records, Cailey Muñana, Ashley Kirzinger, Mollyann Brodie, 18 Mar 2019]
 
*[https://histalk2.com/2019/03/13/readers-write-to-douse-the-flames-of-physician-burnout-target-the-four-biggest-time-wasters-in-the-ehr/ HIStalk - To Douse the Flames of Physician Burnout, Target the Four Biggest Time-Wasters in the EHR, David Butler MD, published 13 Mar 2019]
 
*[https://histalk2.com/2019/03/13/readers-write-to-douse-the-flames-of-physician-burnout-target-the-four-biggest-time-wasters-in-the-ehr/ HIStalk - To Douse the Flames of Physician Burnout, Target the Four Biggest Time-Wasters in the EHR, David Butler MD, published 13 Mar 2019]
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*[https://www.hcinnovationgroup.com/clinical-it/patient-safety/news/21071783/ehrrelated-issues-top-patient-safety-concern-list Healthcare Innovation Group - EHR-Related Issues Top Patient Safety Concern List, David Raths, published 12 Mar 2019]
 
*[https://www.healthcareitnews.com/news/epic-ceo-judy-faulkner-apple-docs-who-actually-their-ehrs-and-warren-buffett Healthcare IT News - Epic CEO Judy Faulkner on Apple, docs who actually like their EHRs..., Mike Miliard, published 13 Feb 2019]
 
*[https://www.healthcareitnews.com/news/epic-ceo-judy-faulkner-apple-docs-who-actually-their-ehrs-and-warren-buffett Healthcare IT News - Epic CEO Judy Faulkner on Apple, docs who actually like their EHRs..., Mike Miliard, published 13 Feb 2019]
*[https://thriveglobal.com/stories/physician-burnout-public-health-crisis-solutions-report/?utm_source=HR19000+WHCC+Care+Delivery+Integration+02012019&utm_medium=email&utm_campaign=HR19000 Thrive Global - Here’s Why Physician Burnout is Officially “A Public Health Crisis”, Jane Burnett, 31 Jan 2019]
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*[https://www.researchgate.net/publication/332691992_Unintended_consequences_of_nationwide_electronic_health_record_adoption_challenges_and_opportunities_in_the_post-Meaningful_Use_era Journal of Medical Internet Research - Unintended Consequences of Nationwide Electronic Health RecordAdoption: Challenges and Opportunities in the Post-MeaningfulUse Era, Tiago K Colicchio PhD MBA, James J Cimino MD, Guilherme Del Fiol MD PhD, published Jan 2019]
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*[https://thriveglobal.com/stories/physician-burnout-public-health-crisis-solutions-report/?utm_source=HR19000+WHCC+Care+Delivery+Integration+02012019&utm_medium=email&utm_campaign=HR19000 Thrive Global - Here’s Why Physician Burnout is Officially “A Public Health Crisis”, Jane Burnett, published 31 Jan 2019]
 
*[https://www.healthit.gov/sites/default/files/page/2018-11/Draft%20Strategy%20on%20Reducing%20Regulatory%20and%20Administrative%20Burden%20Relating.pdf US Office of the National Coordinator for Health Information Technology (ONC) - DRAFT FOR COMMENT - Strategy on Reducing Burden Relating to the Use of Health IT and EHRs, published 28 Nov 2018, comments due 28 Jan 2019]
 
*[https://www.healthit.gov/sites/default/files/page/2018-11/Draft%20Strategy%20on%20Reducing%20Regulatory%20and%20Administrative%20Burden%20Relating.pdf US Office of the National Coordinator for Health Information Technology (ONC) - DRAFT FOR COMMENT - Strategy on Reducing Burden Relating to the Use of Health IT and EHRs, published 28 Nov 2018, comments due 28 Jan 2019]
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*[http://www.massmed.org/News-and-Publications/MMS-News-Releases/Physician-Burnout-Report-2018/ Massachusetts Medical Society, Massachusetts Health and Hospital Association, Harvard T.H. Chan School of Public Health, Harvard Global Health Institute - A Crisis in Health Care: A Call to Action on Physician Burnout, published 18 Nov 2018]
 
*[https://www.healthdatamanagement.com/news/ama-president-calls-for-end-to-electronic-health-record-abuse Health Data Management, AMA president calls for end to electronic health record abuse, Greg Slabodkin, published 14 Nov 2018]
 
*[https://www.healthdatamanagement.com/news/ama-president-calls-for-end-to-electronic-health-record-abuse Health Data Management, AMA president calls for end to electronic health record abuse, Greg Slabodkin, published 14 Nov 2018]
 
*[https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers The New Yorker/Annals of Medicine - Why Doctors Hate Their Computers, Atul Gawande, published 12 Nov 2018]
 
*[https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers The New Yorker/Annals of Medicine - Why Doctors Hate Their Computers, Atul Gawande, published 12 Nov 2018]
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*[https://nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care/ National Academy of Medicine - Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care, Lotte N. Dyrbye, Tait D. Shanafelt, Christine A. Sinsky, Pamela F. Cipriano, Jay Bhatt, Alexander Ommaya, Colin P. West, and David Meyers, published 5 Jul 2017]
 
*[https://nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care/ National Academy of Medicine - Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care, Lotte N. Dyrbye, Tait D. Shanafelt, Christine A. Sinsky, Pamela F. Cipriano, Jay Bhatt, Alexander Ommaya, Colin P. West, and David Meyers, published 5 Jul 2017]
 
*[http://annals.org/aim/fullarticle/2614079/putting-patients-first-reducing-administrative-tasks-health-care-position-paper American College of Physicians - Putting Patients First by Reducing Administrative Tasks in Health Care, Shari M. Erickson MPH, Brooke Rockwern MPH, Michelle Koltov MPH, Robert M. McLean MD, published 2 May 2017]
 
*[http://annals.org/aim/fullarticle/2614079/putting-patients-first-reducing-administrative-tasks-health-care-position-paper American College of Physicians - Putting Patients First by Reducing Administrative Tasks in Health Care, Shari M. Erickson MPH, Brooke Rockwern MPH, Michelle Koltov MPH, Robert M. McLean MD, published 2 May 2017]
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*[https://www.mayoclinicproceedings.org/article/S0025-6196(16)30625-5/pdf Mayo Clinic - Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout, Tait D Shanafelt MD, John H. Noseworthy MD, published Jan 2017]
 
*[https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-physician-survey-hit-factsheet.pdf Deloitte Survey of US Physicians - Findings on health information technology and electronic health records, published 3 Oct 2016]
 
*[https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-physician-survey-hit-factsheet.pdf Deloitte Survey of US Physicians - Findings on health information technology and electronic health records, published 3 Oct 2016]
 
*[https://ehrintelligence.com/news/tips-for-reversing-physician-burnout-caused-by-ehr-use EHR Intelligence - Tips for Reversing Physician Burnout Caused by EHR Use, Sheri Stoltenberg, published 16 Oct 2016]
 
*[https://ehrintelligence.com/news/tips-for-reversing-physician-burnout-caused-by-ehr-use EHR Intelligence - Tips for Reversing Physician Burnout Caused by EHR Use, Sheri Stoltenberg, published 16 Oct 2016]

Revision as of 03:12, 18 September 2019

The Reducing Clinician Burden (RCB) Project is an activity of the HL7 Electronic Health Record Work Group (EHR WG).

Please subscribe to the HL7 EHR WG listserver for meeting announcements, agendas and updates regarding current work.

The RCB Project team meets via teleconference on the 1st and 3rd Mondays each month - at 3PM ET (US). To join the teleconference: https://global.gotomeeting.com/meeting/join/798931918

NOTE: DRAFT documents may be incomplete and are posted for Team review and discourse. Please take care to note their draft (tentative) status if referencing or sharing with others.


HL7 RCB Project - Presentations

HL7 RCB Project - Analysis Worksheet

"See What We Mean"

HL7 RCB Project - Reducing Burden and Addressing Burnout - Success Stories

HL7 RCB Project - Survey and Responses

HL7 RCB Project - Focus Team Drafts

US Office of National Coordinator for Health Information Technology (ONC) DRAFT "Strategy on Reducing Burden"

HL7 RCB Project - Reference Sources