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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.
  
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
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The RCB Project team meets via teleconference on the 1st, 3rd and 5th 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.
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==HL7 RCB Project - Presentations==
 
==HL7 RCB Project - Presentations==
  
*[[media:Reducing_Clinician_Burden-Overview-20200601.pdf|DRAFT Reducing Clinician Burden Project Overview, updated 1 Jun 2020]]
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*[[media:Reducing_Clinician_Burden-Overview-20200921.pdf|DRAFT Reducing Clinician Burden Project Overview, updated 21 Sep 2020]]
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*[[media:Burden_Reduction_OBRHI_9-21-2020.pdf|Interoperability and Burden Reduction - Emerging Opportunities for Collaborative Care, Denise St Clair PhD, US Centers for Medicare and Medicaid Services, Office of Burden Reduction and Health Informatics, presented 21 Sep 2020]]
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*[https://www.dropbox.com/s/bythlco0ss8j89g/RCB%20Opelka%202020.pdf?dl=0 Reducing Clinical Burden thru Knowledge Engineering - Curating Clinical Knowledge, Frank Opelka MD FACS, American College of Surgeons, presented 21 Sep 2020]
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*[[media:POHR_and_reducing_clinician_burden_2020-08-17_wLinks.pdf|The Problem-Oriented Health Record (POHR) and a Pathway to Reducing Clinician Burden (with Links), Lincoln Weed, Chris Weed, presented 17 Aug 2020]]
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*[[media:POHR_and_reducing_clinician_burden_2020-08-17_wNotes.pdf|The Problem-Oriented Health Record (POHR) and a Pathway to Reducing Clinician Burden (with Notes), Lincoln Weed, Chris Weed, presented 17 Aug 2020]]
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*[[media:V3Diagnostic_Advanced_Payment_ModelsHL7.pdf|Payment Reform in the Era of Advanced Diagnostics, Artificial Intelligence and Machine Learning, James Sorace MD MS, presented 3 Aug 2020]]
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*[[media:HL7_RCB_Presentation-Mullins-20200720.pdf|Examining the Health IT Vendor’s Perspective - Lessons learned as a physician working for a health IT vendor, Ryan Mullins MD CPE, presented 20 Jul 2020]]
 
*[https://confluence.hl7.org/download/attachments/39160937/20200518%20Da%20Vinci%20-%20RCB%20Presentation.pptx?version=1&modificationDate=1589915917527&api=v2 HL7 Da Vinci Project Overview (focused on Provider/Payer Exchange), Viet Nguyen MD, presented 18 May 2020]
 
*[https://confluence.hl7.org/download/attachments/39160937/20200518%20Da%20Vinci%20-%20RCB%20Presentation.pptx?version=1&modificationDate=1589915917527&api=v2 HL7 Da Vinci Project Overview (focused on Provider/Payer Exchange), Viet Nguyen MD, presented 18 May 2020]
 
*[https://confluence.hl7.org/display/DVP/Da+Vinci+2020+Calendar HL7 Da Vinci Project Calendar, Viet Nguyen MD, presented 18 May 2020]
 
*[https://confluence.hl7.org/display/DVP/Da+Vinci+2020+Calendar HL7 Da Vinci Project Calendar, Viet Nguyen MD, presented 18 May 2020]
*[[media:DQ_and_RCB_Complexity_Simplified_May_4_2020.pdf|Data Quality and Clinician Burden - Overview, Examples, and Basic Recommendations, Reed Gelzer MD, presented 4 May 2020, followup session planned for 1 Jun 2020]]
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*[[media:DQ_and_RCB_Complexity_Simplified_May_4_2020.pdf|Data Quality and Clinician Burden - Overview, Examples, and Basic Recommendations, Reed Gelzer MD, presented 4 May and 1 Jun 2020]]
 
*[[media:EHR_WG_Update_20April2020.pdf|Exploring FHIR to Reduce Burden for Quality Measurement, Floyd Eisenberg MD PhD, presented 20 Apr 2020]]
 
*[[media:EHR_WG_Update_20April2020.pdf|Exploring FHIR to Reduce Burden for Quality Measurement, Floyd Eisenberg MD PhD, presented 20 Apr 2020]]
 
*[[media:HL7_Interactive_fhir_FINAL_14April2020_with_results-1.pdf|Exploring FHIR to Reduce Burden for Quality Measurement - Survey Results, Floyd Eisenberg MD PhD, presented 20 Apr 2020]]
 
*[[media:HL7_Interactive_fhir_FINAL_14April2020_with_results-1.pdf|Exploring FHIR to Reduce Burden for Quality Measurement - Survey Results, Floyd Eisenberg MD PhD, presented 20 Apr 2020]]
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==HL7 RCB Project - Analysis Worksheets==
 
==HL7 RCB Project - Analysis Worksheets==
*[[media:Reducing_Clinician_Burden_Analysis_Worksheet-20200601.xlsx|DRAFT Reducing Clinician Burden Analysis Worksheet, updated 1 Jun 2020]]
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*[[media:Reducing_Clinician_Burden_Analysis_Worksheet-20200921.xlsx|DRAFT Reducing Clinician Burden Analysis Worksheet, updated 21 Sep 2020]]
NOTE that this version of the RCB Analysis Worksheet includes the ONC FINAL "Strategy on Reducing Burden Relating to the Use of Health IT and EHRs".  Each of the four ONC Initiatives(I), along with Strategies(S) and Recommendations(R) are inserted within the related RCB topic/category and are identified as Ix.Sx.Rx.  NOTE also that all reference sources up through #106 have been reviewed and are incorporated in this version.  See "References" Tab.
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This version of the RCB Analysis Worksheet includes the ONC FINAL "Strategy on Reducing Burden Relating to the Use of Health IT and EHRs".  Each of the four ONC Initiatives(I), along with Strategies(S) and Recommendations(R) are inserted within the related RCB topic area and are identified as Ix.Sx.Rx.  NOTE also that all reference sources up through #119 have been reviewed and are incorporated in this version.  See "References" Tab.
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*[[media:Reducing_Clinician_Burden-Cause_Matrix-20200615.pdf|DRAFT Reducing Clinician Burden - Cause Matrix, updated 15 Jun 2020]]
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This one page DRAFT outlines key causal factors for clinician burden and is offered for your review and comment.
 
*[[media:IPS-Burden_Comments-20200330.pdf|RCB-related Comments on ISO DIS 27269 - International Patient Summary, published 30 Mar 2020]]
 
*[[media:IPS-Burden_Comments-20200330.pdf|RCB-related Comments on ISO DIS 27269 - International Patient Summary, published 30 Mar 2020]]
NOTE that comments on the DRAFT International Patient Summary were prepared in correspondence with findings of the HL7 RCB Project and clinician burdens associated with patient summary creation, exchange and use, particularly with regard to aspects of information overload, data integrity, patient/provider identity matching, preservation of clinical data context and reconciliation of medications, medication allergies, all allergies and problems/diagnoses.
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These comments on the DRAFT International Patient Summary were prepared in correspondence with findings of the HL7 RCB Project and clinician burdens associated with patient summary creation, exchange and use, particularly with regard to aspects of information overload, data integrity, patient/provider identity matching, preservation of clinical data context, reconciliation of medications, medication allergies, all allergies, problems/diagnoses and more.
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*[[media:HL7_EHR_WG-A_Perspective_on_History_and_the_Future-20200730.pdf|“A Perspective on the History and Progression of EHR System Functionality Standards, Certification and Adoption”, updated 30 Jul 2020]]
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This document is part of an initial dialogue between the HL7 RCB Project and the US Centers for Medicare and Medicaid Services (CMS) Office of Burden Reduction and Health Informatics and offers a timeline of HL7 EHR WG standards development activities from 2000 until the present.
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==HL7 RCB Project - Reducing Clinician Burden "Comment Only" Ballot==
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*[[media:HL7_RCB_R1_O1_2020SEP.pdf|RCB Ballot Document - September 2020 Ballot Cycle - To Gain Insights/Input from the HL7 International Community on Workable Strategies for Clinician Burden Reduction]]
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*[[media:Reducing_Clinician_Burden-Ballot_Comments-20200914.xlsx|RCB Ballot Comments (from Participants)]]
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This ballot closed on Monday, 14 September 2020.
  
 
==HL7 RCB Project - White Paper==
 
==HL7 RCB Project - White Paper==
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*[https://www.logicahealth.org/covid-19-interoperability-project/ Logica COVID-19 Interoperability Project, posted 4 Apr 2020]
 
*[https://www.logicahealth.org/covid-19-interoperability-project/ Logica COVID-19 Interoperability Project, posted 4 Apr 2020]
 
*[https://covid-19-ig.logicahealth.org/?mc_cid=709e81f39c&mc_eid=10d45eb01b Logica COVID-19 FHIR Implementation Guide, posted 4 Apr 2020]
 
*[https://covid-19-ig.logicahealth.org/?mc_cid=709e81f39c&mc_eid=10d45eb01b Logica COVID-19 FHIR Implementation Guide, posted 4 Apr 2020]
 
==Reducing Clinician Burden/Burnout - Call for Papers==
 
*[https://academic.oup.com/jamia/pages/call-for-papers-clinician-burnout Journal of the American Medical Informatics Association (JAMIA) - Call for Papers for Special Focus Issue on Clinician Burnout - Informatics Perspectives, submission deadline 26 Jun 2020]
 
  
 
=="See What We Mean"==
 
=="See What We Mean"==
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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]]
 
*[[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]]
 
*[[media:CentriHealth-Comments_on_ONC_DRAFT_Burden_Reduction_Strategy.pdf|CentriHealth Comments on ONC DRAFT Strategy, submitted 28 Jan 2019]]
 
*[[media:CentriHealth-Comments_on_ONC_DRAFT_Burden_Reduction_Strategy.pdf|CentriHealth Comments on ONC DRAFT Strategy, submitted 28 Jan 2019]]
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*[https://www.urban.org/policy-centers/health-policy-center/projects/electronic-health-record-reporting-program ONC/Urban Institute - Health Policy Center - DRAFT Electronic Health Record Reporting Program, published Jun 2020]
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*[[media:Ehr_draft_voluntary_user-reported_criteria-GLD-20200810.pdf|EHR Standards Consulting - Comments on the ONC/Urban Institute DRAFT Electronic Health Record Reporting Program, submitted 10 Aug 2020]]
  
 
==US Department of Health and Human Services (HHS) Patients over Paperwork Initiative==
 
==US Department of Health and Human Services (HHS) Patients over Paperwork Initiative==
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==HL7 RCB Project - Reference Sources==
 
==HL7 RCB Project - Reference Sources==
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*[https://nam.edu/electronic-health-record-optimization-and-clinician-well-being-a-potential-roadmap-toward-action/ National Academy of Medicine - Electronic Health Record Optimization and Clinician Well-Being: A Potential Roadmap Toward Action, Tina Shah MD MPH, Andrea Borondy Kitts MS MPH, Jeffrey A Gold MD, Keith Horvath MD, Alex Ommaya DSc, Frank Opelka MD FACS, Luke Sato MD, Gretchen Schwarze MD MPP FACS, Mark Upton MD, Lew Sandy MD MBA, published 3 Aug 2020]
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*[https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2020.00612 Practice And Policy Reset Post-COVID-19: Reversion, Transition, Or Transformation? Christine Sinsky MD, Mark Linzer MD, published Aug 2020]
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*[https://ehrintelligence.com/news/high-ehr-inbox-volume-is-the-leading-cause-of-clinician-burnout EHR Intelligence - High EHR Inbox Volume is the Leading Cause of Clinician Burnout - Outside of the copy and paste method EHR efficiency tools do not reduce clinician burnout, Christopher Jason, published 29 Jul 2020]
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*[https://ehrintelligence.com/news/vanderbilt-launches-program-to-mitigate-ehr-alerts-clinician-burnout EHR Intelligence - Vanderbilt Launches Program to Mitigate EHR Alerts and Clinician Burnout - Program has already reduced the weekly average of EHR alerts by 10 percent - Reducing clinician burnout at Vanderbilt University Medical Center, Christopher Jason, published 21 Jul 2020]
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*[https://www.healthleadersmedia.com/clinical-care/physician-fatigue-linked-electronic-health-record-use HealthLeaders Media - Physician Fatigue linked to Electronic Health Record Use, Christopher Cheney, published 20 Jul 2020]
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*[https://www.ama-assn.org/practice-management/digital/how-create-better-ehr-usability-enhance-physicians-lives American Medical Association - How to create better EHR usability to enhance physicians’ lives, Sara Berg, published 16 Jul 2020]
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*[https://www.cms.gov/newsroom/press-releases/cms-unveils-major-organizational-change-reduce-provider-and-clinician-burden-and-improve-patient US Centers for Medicare and Medicaid Services Unveils Major Organizational Change to Reduce Provider and Clinician Burden and Improve Patient Outcomes, published 23 Jun 2020]
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*[https://www.healio.com/news/psychiatry/20200616/ehrrelated-fatigue-may-lead-to-inefficient-use-among-physicians Healio/Psychiatry - EHR-related fatigue may lead to inefficient use among physicians, Joe Gramigna MA, published 16 Jun 2020]
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*[https://ehrintelligence.com/news/ehr-implementation-leads-to-significant-physician-burnout-anxiety EHR Intelligence - EHR Implementation Leads to Significant Physician Burnout and Anxiety - Notable changes in the workplace (such as EHR implementation and adoption) are leading causes of physician burnout, Christopher Jason, published 5 Jun 2020]
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*[https://www.healthcareitnews.com/news/fight-nurse-burnout-ehrs-must-use-ai-reflect-rn-specific-workflows Healthcare IT News - To fight nurse burnout, EHRs must use AI, reflect RN-specific workflows, Bill Siwicki, published 2 Jun 2020]
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*[https://www.healthcareitnews.com/news/ehrs-still-posing-big-safety-risks-many-hospitals Healthcare IT News - EHRs still posing big safety risks in many hospitals, Kat Jercich, published 2 Jun 2020]
 
*[https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2764862 Journal of the American Medical Association - Commercial Influences on Electronic Health Records and Adverse Effects on Clinical Decision Making, Julie K Taitsman MD JD, Andrew VanLandingham JD, Christi A Grimm MPA, published 11 May 2020]
 
*[https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2764862 Journal of the American Medical Association - Commercial Influences on Electronic Health Records and Adverse Effects on Clinical Decision Making, Julie K Taitsman MD JD, Andrew VanLandingham JD, Christi A Grimm MPA, published 11 May 2020]
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*[https://ehrintelligence.com/news/heavy-ehr-workload-leads-to-higher-clinician-burnout-exhaustion EHR Intelligence - Heavy EHR Workload Leads to Higher Clinician Burnout and Exhaustion - Researchers found that clinicians are engaging with over 300 messages in the EHR on a weekly basis, resulting in clinician burnout, Christopher Jason, published 7 Apr 2020]
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*[https://www.jmir.org/2020/7/e19126/ Journal of Medical Informatics Research - Information Overload in Emergency Medicine Physicians - A Multisite Case Study Exploring the Causes, Impact, and Solutions in Four North England National Health Service Trusts, Laura Sbaffi1 BSc MSc MA DPhil, James Walton BSc MBChB MRCEM FRCEM John Blenkinsopp BA, Graham Walton BSc MA MBA DPhil. published 4 Apr 2020]
 
*[https://www.healthaffairs.org/do/10.1377/hblog20200226.453011/full/?mi=3u3irl&af=R&ConceptID=891&content=blog&countTerms=true&target=topic-blog& Health Affairs - To Measure The Burden Of EHR Use, Audit Logs Offer Promise - But Not Without Further Collaboration, Genna Cohen, Llewelyn Brown, Megan Fitzgerald, Anita Somplasky, published 28 Feb 2020]
 
*[https://www.healthaffairs.org/do/10.1377/hblog20200226.453011/full/?mi=3u3irl&af=R&ConceptID=891&content=blog&countTerms=true&target=topic-blog& Health Affairs - To Measure The Burden Of EHR Use, Audit Logs Offer Promise - But Not Without Further Collaboration, Genna Cohen, Llewelyn Brown, Megan Fitzgerald, Anita Somplasky, published 28 Feb 2020]
 
*[https://www.ama-assn.org/practice-management/physician-health/10-medical-specialties-10-different-ways-cut-physician-burnout American Medical Association - Practice Management - 10 medical specialties, 10 different ways to cut physician burnout, Sara Berg, published 13 Feb 2020]
 
*[https://www.ama-assn.org/practice-management/physician-health/10-medical-specialties-10-different-ways-cut-physician-burnout American Medical Association - Practice Management - 10 medical specialties, 10 different ways to cut physician burnout, Sara Berg, published 13 Feb 2020]

Revision as of 04:37, 22 September 2020

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, 3rd and 5th 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 Worksheets

This version of the RCB Analysis Worksheet includes the ONC FINAL "Strategy on Reducing Burden Relating to the Use of Health IT and EHRs". Each of the four ONC Initiatives(I), along with Strategies(S) and Recommendations(R) are inserted within the related RCB topic area and are identified as Ix.Sx.Rx. NOTE also that all reference sources up through #119 have been reviewed and are incorporated in this version. See "References" Tab.

This one page DRAFT outlines key causal factors for clinician burden and is offered for your review and comment.

These comments on the DRAFT International Patient Summary were prepared in correspondence with findings of the HL7 RCB Project and clinician burdens associated with patient summary creation, exchange and use, particularly with regard to aspects of information overload, data integrity, patient/provider identity matching, preservation of clinical data context, reconciliation of medications, medication allergies, all allergies, problems/diagnoses and more.

This document is part of an initial dialogue between the HL7 RCB Project and the US Centers for Medicare and Medicaid Services (CMS) Office of Burden Reduction and Health Informatics and offers a timeline of HL7 EHR WG standards development activities from 2000 until the present.

HL7 RCB Project - Reducing Clinician Burden "Comment Only" Ballot

This ballot closed on Monday, 14 September 2020.

HL7 RCB Project - White Paper

This White Paper has been released for Project Team review and comment.

Burden Reduction (and other) Initiatives in Response to the COVID-19 Pandemic

"See What We Mean"

HL7 RCB Project - Reducing Burden - Success Stories

HL7 RCB Project - Survey and Responses

HL7 RCB Project - Focus Team Drafts

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

US Department of Health and Human Services (HHS) Patients over Paperwork Initiative

More RCB Perspectives and Resources

HL7 RCB Project - Reference Sources