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==HL7 RCB Project - Presentations==
 
==HL7 RCB Project - Presentations==
  
*[[media:Reducing_Clinician_Burden-Overview-20200120.pdf|DRAFT Reducing Clinician Burden Project Overview, updated 20 Jan 2020]]
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*[[media:Reducing_Clinician_Burden-Overview-20200803.pdf|DRAFT Reducing Clinician Burden Project Overview, updated 3 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]]
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*[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]
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*[https://confluence.hl7.org/display/DVP/Da+Vinci+2020+Calendar HL7 Da Vinci Project Calendar, Viet Nguyen MD, presented 18 May 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]]
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*[[media:EHR_WG_Update_20April2020.pdf|Exploring FHIR to Reduce Burden for Quality Measurement, Floyd Eisenberg MD PhD, presented 20 Apr 2020]]
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*[[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:Association_Between_EHR_Usability_and_Burnout_DS_20191118.pdf|Association between EHR Usability and Burnout, David Schlossman MD, presented 18 Nov 2019]]
 
*[[media:Association_Between_EHR_Usability_and_Burnout_DS_20191118.pdf|Association between EHR Usability and Burnout, David Schlossman MD, presented 18 Nov 2019]]
 
*[[media:HL7_EHR-S_FM_Usability_FP_Relationship_to_RCB_Project_DS_20191007.pdf|Increasing EHR System Usability Through Standards - As One Approach to Reducing Clinician Burden, David Schlossman MD, presented 7 Oct 2019]]
 
*[[media:HL7_EHR-S_FM_Usability_FP_Relationship_to_RCB_Project_DS_20191007.pdf|Increasing EHR System Usability Through Standards - As One Approach to Reducing Clinician Burden, David Schlossman MD, presented 7 Oct 2019]]
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==HL7 RCB Project - Analysis Worksheets==
 
==HL7 RCB Project - Analysis Worksheets==
*[[media:Reducing_Clinician_Burden_Analysis_Worksheet-20200106.xlsx|DRAFT Reducing Clinician Burden Analysis Worksheet, DRAFT IN PROGRESS - COMMENTS ARE WELCOME!! dated 6 Jan 2020]]
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*[[media:Reducing_Clinician_Burden_Analysis_Worksheet-20200803.xlsx|DRAFT Reducing Clinician Burden Analysis Worksheet, updated 3 Aug 2020]]
*[[media:Reducing_Clinician_Burden-Patient_Summary_Analysis-20191104.xlsx|Reducing Clinician Burden - Patient Summary - Analysis Worksheet, DRAFT IN PROGRESS - COMMENTS ARE WELCOME!! dated 4 Nov 2019]]
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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.
*[[media:RCB-Data_Quality_Burdens-20191021.pdf|DRAFT Data Quality Burden, dated 21 Oct 2019]]
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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.
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*[[media:IPS-Burden_Comments-20200330.pdf|RCB-related Comments on ISO DIS 27269 - International Patient Summary, published 30 Mar 2020]]
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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:Reducing_Clinician_Burden-Comment_Only_Ballot-20200809b.pdf|Ballot Overview and Response Document - September 2020 Ballot Cycle - To Gain Insights/Input from the HL7 International Community on Workable Strategies for Clinician Burden Reduction, updated 9 Aug 2020]]
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==HL7 RCB Project - White Paper==
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*[[media:RCB_Project_Clinical_Workflow_Paper_JMIR_Format_21Jan2020-Final.docx|DRAFT Reducing Clinician Burden by Improving Electronic Health Record Usability and Support for Clinical Workflow, David Schlossman MD PhD, Lisa Masson MD, James Tcheng MD, Luann Whittenburg RN PhD, Barry Newman MD, Gary Dickinson FHL7, released 1 Jun 2020]]
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This White Paper has been released for Project Team review and comment.
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==Burden Reduction (and other) Initiatives in Response to the COVID-19 Pandemic==
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*[https://www.cms.gov/files/document/cms-waivers-and-covid-19-response.pdf (US) Centers for Medicare and Medicaid Services (CMS) - Waivers and COVID-19 Response, Online Presentation, 7 April 2020]
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*[https://www.cms.gov/newsroom/press-releases/cms-announces-relief-clinicians-providers-hospitals-and-facilities-participating-quality-reporting (US) CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19, posted 22 Mar 2020]
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*[https://www.cms.gov/newsroom/press-releases/trump-administration-makes-sweeping-regulatory-changes-help-us-healthcare-system-address-covid-19 (US) Trump Administration Makes Sweeping Regulatory Changes to Help U.S. Healthcare System Address COVID-19 Patient Surge, posted 30 Mar 2020]
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*[https://www.hcinnovationgroup.com/interoperability-hie/standards/article/21131620/hitac-brainstorms-ways-onc-can-help-frontline-providers-in-covid19-response (US) Health Information Technology Advisory Committee (HITAC) Brainstorms Ways ONC Can Help Front-Line Providers in COVID-19 Response, published 27 Mar 2020]
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*[https://www.fiercehealthcare.com/payer/humana-aims-to-ease-administrative-financial-burdens-providers-amid-covid-19-crisis?utm_medium=nl&utm_source=internal&mrkid=4643083&mkt_tok=eyJpIjoiWmpNME1HRmlPV1E0TkRBeiIsInQiOiJPVXlncCtyNWVqZWdvNFZwQUxxQlpPOWFlOUNwUExHeVZuR2hCV1E4clV4MVVuMXZVQUNQTzIySWpmbEN6N2pkYXhnUkMwSEg1a0V4TTNyaEw1YjE0bnFZdm02Y2Ewb1djeSszUTlKcytjbldJSU9JTVZRQVFsSm1wa1N3bVlBVyJ9 (US Health Plan) Humana easing administrative, financial burdens on providers amid COVID-19 crisis, published 2 Apr 2020]
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*[https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/coronavirus-disease-2019-covid-19/index.html (US) CMS - COVID-19 Disaster Response Toolkit, posted 7 April 2020]
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*[https://www.logicahealth.org/covid-19-interoperability-project/ Logica COVID-19 Interoperability Project, posted 4 Apr 2020]
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*[https://covid-19-ig.logicahealth.org/?mc_cid=709e81f39c&mc_eid=10d45eb01b Logica COVID-19 FHIR Implementation Guide, posted 4 Apr 2020]
  
 
=="See What We Mean"==
 
=="See What We Mean"==
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*[[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]]
  
==US Office of National Coordinator for Health Information Technology (ONC) DRAFT "Strategy on Reducing Burden"==
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==US Office of National Coordinator for Health Information Technology (ONC) Strategy for Reducing Burden==
*[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://www.healthit.gov/topic/2020-2025-federal-health-it-strategic-plan ONC DRAFT Federal Health IT Strategic Plan, 2020-2025 - published 15 Jan 2020]
*[https://healthit.gov/burdencomments Summary of Public Comments for Draft Strategy, published 26 Mar 2019]
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*[https://www.healthit.gov/topic/usability-and-provider-burden/strategy-reducing-burden-relating-use-health-it-and-ehrs ONC FINAL "Strategy on Reducing Burden Relating to the Use of Health IT and EHRs", including Findings, Strategies and Recommendations, published 21 Feb 2020]
*[[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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*[https://healthit.gov/burdencomments Summary of Public Comments on ONC DRAFT Strategy, published 26 Mar 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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*[[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 Comments on ONC DRAFT Strategy, submitted 28 Jan 2019]]
  
 
==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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*[https://edhub.ama-assn.org/steps-forward/module/2702761 American Medical Association - Education Hub - Electronic Health Record Optimization: Strategies for Thriving - Strategies to help health care organizations maximize the benefits and minimize the burdens of the EHR, published 30 Aug 2018]
 
*[https://edhub.ama-assn.org/steps-forward/module/2702761 American Medical Association - Education Hub - Electronic Health Record Optimization: Strategies for Thriving - Strategies to help health care organizations maximize the benefits and minimize the burdens of the EHR, published 30 Aug 2018]
 
*[https://www.youtube.com/watch?v=CCZlFE_R5yg Video - Freeing physicians to do their jobs - 2019 EHR National Symposium - Stanford Medicine, posted 28 Oct 2019]
 
*[https://www.youtube.com/watch?v=CCZlFE_R5yg Video - Freeing physicians to do their jobs - 2019 EHR National Symposium - Stanford Medicine, posted 28 Oct 2019]
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*[https://www.statista.com/topics/2099/stress-and-burnout/ Statista - Stress and burnout - Statistics & Facts, John Elflein, published 16 Aug 2019]
  
 
==HL7 RCB Project - Reference Sources==
 
==HL7 RCB Project - Reference Sources==
*[https://www.medscape.com/slideshow/2020-lifestyle-burnout-6012460?src=WNL_bom_200119_MSCPEDIT&uac=313101EV&impID=2247924&faf=1 Medscape - (US) National Physician Burnout & Suicide Report 2020 - The Generational Divide, Leslie Kane MA, published 15 January 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]
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*[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]
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*[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]
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*[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]
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*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008538/ BMC Medical Informatics and Decision Making - A qualitative study of physician perspectives on adaptation to electronic health records, Cynthia J Sieck, Nicole Pearl, Tiffani J Bright, Po-Yin Yen, published 10 Feb 2020]
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*[https://academic.oup.com/jamia/article/27/4/639/5728718#.XjyP35UizZQ.twitter Journal of the American Medical Informatics Association - Metrics for assessing physician activity using electronic health record log data, Christine A Sinsky, Adam Rule, Genna Cohen, Brian G Arndt, Tait D Shanafelt, Christopher D Sharp, Sally L Baxter, Ming Tai-Seale, Sherry Yan, You Chen, Julia Adler-Milstein, Michelle Hribar, published 6 Feb 2020]
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*[https://www.washingtonpost.com/health/too-many-tests-too-little-time-doctors-say-they-face-moral-injury-because-of-a-business-model-that-interferes-with-patient-care/2020/01/31/c00e9d58-3d3a-11ea-8872-5df698785a4e_story.html Washington Post - Too many tests, too little time: Doctors say they face ‘moral injury’ because of a business model that interferes with patient care, Melissa Bailey, published 1 Feb 2020]
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*[https://www.scientificamerican.com/article/electronic-health-records-need-a-shot-in-the-arm/ Scientific American - Electronic Health Records Need a Shot in the Arm, Cassandra Willyard, published 1 Feb 2020]
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*[https://www.sciencedirect.com/science/article/pii/S1386505619306835 International Journal of Medical Informatics - Physicians' and nurses’ experiences on EHR usability: Comparison between the professional groups by employment sector and system brand, Johanna Kaipioa, Anne Kuusistob, Hannele Hyppönenc, Tarja Heponiemic, Tinja Lääverid, published Feb 2020]
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*[https://www.medscape.com/slideshow/2020-lifestyle-burnout-6012460?src=WNL_bom_200119_MSCPEDIT&uac=313101EV&impID=2247924&faf=1 Medscape - (US) National Physician Burnout & Suicide Report 2020 - The Generational Divide, Leslie Kane MA, published 15 Jan 2020]
 
*[https://www.forbes.com/sites/brucelee/2020/01/13/electronic-health-records-here-is-how-much-time-doctors-are-spending-with-them/#bfe5b795172a Forbes - How Doctors May Be Spending More Time With Electronic Health Records Than Patients, Bruce Y Lee, published 13 Jan 2020]
 
*[https://www.forbes.com/sites/brucelee/2020/01/13/electronic-health-records-here-is-how-much-time-doctors-are-spending-with-them/#bfe5b795172a Forbes - How Doctors May Be Spending More Time With Electronic Health Records Than Patients, Bruce Y Lee, published 13 Jan 2020]
 
*[https://www.nytimes.com/2019/12/31/opinion/doctors-nurses-and-the-paperwork-crisis-that-could-unite-them.html New York Times - Doctors, Nurses and the Paperwork Crisis That Could Unite Them, Theresa Brown, Stephen Bergman, published 31 Dec 2019]
 
*[https://www.nytimes.com/2019/12/31/opinion/doctors-nurses-and-the-paperwork-crisis-that-could-unite-them.html New York Times - Doctors, Nurses and the Paperwork Crisis That Could Unite Them, Theresa Brown, Stephen Bergman, published 31 Dec 2019]
 
*[https://fortune.com/longform/electronic-health-records-fraud/ Fortune Magazine/Kaiser Health News - Electronic Health Records Creating a ‘New Era’ of Health Care Fraud, Officials Say, Fred Schulte and Erika Fry, published 23 Dec 2019]
 
*[https://fortune.com/longform/electronic-health-records-fraud/ Fortune Magazine/Kaiser Health News - Electronic Health Records Creating a ‘New Era’ of Health Care Fraud, Officials Say, Fred Schulte and Erika Fry, published 23 Dec 2019]
*[https://www.radiologybusiness.com/topics/leadership/healthcare-artificial-intelligence-burnout Radiology Business - 80% of healthcare pros believe AI is reducing burnout, Marty Stempniak, published 16 December 2019]
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*[https://www.radiologybusiness.com/topics/leadership/healthcare-artificial-intelligence-burnout Radiology Business - 80% of healthcare pros believe AI is reducing burnout, Marty Stempniak, published 16 Dec 2019]
 
*[https://fortune.com/longform/medical-records-government-regulation-patient-risk/ Fortune Magazine/Kaiser Health News - No Safety Switch: How Lax Oversight of Electronic Health Records Puts Patients at Risk - Special interests and congressional inaction doomed efforts to regulate electronic medical records, putting patients at risk, Fred Schulte and Erika Fry, published 21 Nov 2019]
 
*[https://fortune.com/longform/medical-records-government-regulation-patient-risk/ Fortune Magazine/Kaiser Health News - No Safety Switch: How Lax Oversight of Electronic Health Records Puts Patients at Risk - Special interests and congressional inaction doomed efforts to regulate electronic medical records, putting patients at risk, Fred Schulte and Erika Fry, published 21 Nov 2019]
 
*[https://healthit.ahrq.gov/sites/default/files/docs/page/acts-townhall-amia-2019.pdf US Agency for Health Research and Quality - Evidence-based Care Transformation Support (ACTS) Initiative, published 18 Nov 2019]
 
*[https://healthit.ahrq.gov/sites/default/files/docs/page/acts-townhall-amia-2019.pdf US Agency for Health Research and Quality - Evidence-based Care Transformation Support (ACTS) Initiative, published 18 Nov 2019]
 
*[https://federalregister.gov/d/2019-24086 US Federal Register - Medicare Program; CY 2020 Revisions to Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies..., published 15 Nov 2019]
 
*[https://federalregister.gov/d/2019-24086 US Federal Register - Medicare Program; CY 2020 Revisions to Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies..., published 15 Nov 2019]
 
*[https://www.beckershospitalreview.com/ehrs/ama-study-physicians-give-ehr-usability-an-f-rating.html Becker's Healthcare - AMA study - Physicians give EHR usability an 'F' rating, Jackie Drees, published 14 Nov 2019]
 
*[https://www.beckershospitalreview.com/ehrs/ama-study-physicians-give-ehr-usability-an-f-rating.html Becker's Healthcare - AMA study - Physicians give EHR usability an 'F' rating, Jackie Drees, published 14 Nov 2019]
*[https://www.healthdatamanagement.com/news/cms-final-rule-aims-to-reduce-physician-billing-coding-burdens?position=editorial_1&campaignname=HDM_Weekly_Best%20of%20the%20Week-11082019&utm_source=newsletter&utm_medium=email&utm_campaign=HDM_Weekly_Best+of+the+Week%2B%27-%27%2B11082019&bt_ee=Wn4gzyECjQgzn1CaTKaNLpxZBRuC2xP%2FDOWpxkxJnWd8EVo%2BPQZbo7kBeqs1VKqjjPqMYwu6aW5I7Jrk5PVDcg%3D%3D&bt_ts=1573254130350 Health Data Management - CMS final rule aims to reduce physician billing and coding burdens, Greg Slabodkin, published 4 November 2019]
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*[https://www.healthdatamanagement.com/news/cms-final-rule-aims-to-reduce-physician-billing-coding-burdens?position=editorial_1&campaignname=HDM_Weekly_Best%20of%20the%20Week-11082019&utm_source=newsletter&utm_medium=email&utm_campaign=HDM_Weekly_Best+of+the+Week%2B%27-%27%2B11082019&bt_ee=Wn4gzyECjQgzn1CaTKaNLpxZBRuC2xP%2FDOWpxkxJnWd8EVo%2BPQZbo7kBeqs1VKqjjPqMYwu6aW5I7Jrk5PVDcg%3D%3D&bt_ts=1573254130350 Health Data Management - CMS final rule aims to reduce physician billing and coding burdens, Greg Slabodkin, published 4 Nov 2019]
 
*[https://www.nap.edu/catalog/25521/taking-action-against-clinician-burnout-a-systems-approach-to-professional National Academy of Medicine - Taking Action Against Clinician Burnout, 23 Oct 2019]
 
*[https://www.nap.edu/catalog/25521/taking-action-against-clinician-burnout-a-systems-approach-to-professional National Academy of Medicine - Taking Action Against Clinician Burnout, 23 Oct 2019]
 
*[https://www.hcinnovationgroup.com/clinical-it/physician-burnout/article/21111643/preventing-physician-burnout-on-the-front-lines-hit-execs-share-their-perspectives-part-2 Healthcare Innovation - Preventing Physician Burnout on the Front Lines: HIT Execs Share Their Perspectives (Part 2), Rajiv Leventhal, 24 Oct 2019]
 
*[https://www.hcinnovationgroup.com/clinical-it/physician-burnout/article/21111643/preventing-physician-burnout-on-the-front-lines-hit-execs-share-their-perspectives-part-2 Healthcare Innovation - Preventing Physician Burnout on the Front Lines: HIT Execs Share Their Perspectives (Part 2), Rajiv Leventhal, 24 Oct 2019]
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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]
 
*[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]
 
*[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]
 
*[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]
*[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.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 Jul 2019]
 
*[http://www.annfammed.org/content/17/4/367.full.pdf Annals of Family Medicine - Powering-Up Primary Care Teams: Advanced Team Care With In-Room Support, Christine A Sinsky, Thomas Bodenheimer MD MPH, Jul 2019]
 
*[http://www.annfammed.org/content/17/4/367.full.pdf Annals of Family Medicine - Powering-Up Primary Care Teams: Advanced Team Care With In-Room Support, Christine A Sinsky, Thomas Bodenheimer MD MPH, Jul 2019]
 
*[https://www.spok.com/clinicianburnout Spok - Clinician Burnout in Healthcare: A Report for Healthcare Leaders, published Jul 2019]
 
*[https://www.spok.com/clinicianburnout Spok - Clinician Burnout in Healthcare: A Report for Healthcare Leaders, published Jul 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]
 
*[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]
 
*[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]
 
*[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]
*[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]
+
*[https://searchhealthit.techtarget.com/feature/Physician-burnout-eased-with-homegrown-tech TechTarget - Kaiser Permanente - Physician burnout eased with homegrown tech, Makenzie Holland, published 24 Apr 2019]
*[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]
+
*[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 Apr 2019]
 
*[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]
 
*[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]
 
*[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]
 
*[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.ncbi.nlm.nih.gov/pmc/articles/PMC5899365/ Predictors of physicians’ stress related to information systems: A nine-year follow-up survey study. BMC Health Services Research, Tarja Heponiemi, Hannele Hyppönen, Sari Kujala, Anna-Mari Aalto, Tuulikki Vehko, Jukka Vänskä, Marko Elovainio, published 13 Apr 2018]
 
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5899365/ Predictors of physicians’ stress related to information systems: A nine-year follow-up survey study. BMC Health Services Research, Tarja Heponiemi, Hannele Hyppönen, Sari Kujala, Anna-Mari Aalto, Tuulikki Vehko, Jukka Vänskä, Marko Elovainio, published 13 Apr 2018]
 
*[https://ehrintelligence.com/news/nqf-advises-cms-align-quality-measures-cut-administrative-burden EHR Intelligence - NQF Advises CMS Align Quality Measures, Cut Administrative Burden, Kate Monica, published 3 Apr 2018]
 
*[https://ehrintelligence.com/news/nqf-advises-cms-align-quality-measures-cut-administrative-burden EHR Intelligence - NQF Advises CMS Align Quality Measures, Cut Administrative Burden, Kate Monica, published 3 Apr 2018]
*[https://link.springer.com/article/10.1007/s11606-017-4228-2 Journal of General Internal Medicine - Keystrokes, Mouse Clicks, and Gazing at the Computer: How Physician Interaction with the EHR Affects Patient Participation, Richard L. Street Jr, Lin Liu, Neil J. Farber, Yunan Chen, Alan Calvitti, Nadir Weibel, Mark T. Gabuzda, Kristin Bell, Barbara Gray, Steven Rick, Shazia Ashfaq, Zia Agha, published April 2018]
+
*[https://link.springer.com/article/10.1007/s11606-017-4228-2 Journal of General Internal Medicine - Keystrokes, Mouse Clicks, and Gazing at the Computer: How Physician Interaction with the EHR Affects Patient Participation, Richard L. Street Jr, Lin Liu, Neil J. Farber, Yunan Chen, Alan Calvitti, Nadir Weibel, Mark T. Gabuzda, Kristin Bell, Barbara Gray, Steven Rick, Shazia Ashfaq, Zia Agha, published Apr 2018]
 
*[http://www.physicianspractice.com/himss/reducing-clinician-burnout-five-ehr-related-areas Physician Practice - Reducing Clinician Burnout in Five EHR-Related Areas, Gabriel Perna, published 9 Mar 2018]
 
*[http://www.physicianspractice.com/himss/reducing-clinician-burnout-five-ehr-related-areas Physician Practice - Reducing Clinician Burnout in Five EHR-Related Areas, Gabriel Perna, published 9 Mar 2018]
 
*[https://www.healthcare-informatics.com/article/ehr/clinicians-cms-onc-right-ship-simplify-reporting-ease-regulatory-burdens Healthcare Informatics - Clinicians to CMS, ONC: “Right the Ship” to Simplify Reporting, Ease Regulatory Burdens, Heather Landi, published 13 Feb 2018]
 
*[https://www.healthcare-informatics.com/article/ehr/clinicians-cms-onc-right-ship-simplify-reporting-ease-regulatory-burdens Healthcare Informatics - Clinicians to CMS, ONC: “Right the Ship” to Simplify Reporting, Ease Regulatory Burdens, Heather Landi, published 13 Feb 2018]

Latest revision as of 16:33, 9 August 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 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 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

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