Transformations to reduce EHR usability burden

Your investment of time and resources to adopt one of these new environments will ultimately pay significant dividends: reduced burden and more meaningful time with patients.

The team model relieves burden by delegating EHR tasks to other members of the care team. In this model’s simplest form, the physician tasks a medical assistant (MA) with documenting and clinically assisting during the visit.

The MA begins taking notes with the patient prior to the physician entering the room, then stays and acts as a scribe. The MA also operates as a clinical assistant, preparing the patient for the visit, as well as for after-visit care.

Family medicine practices typically partner each physician with one MA. The team-based care model puts more responsibilities on the MA per visit, and some practices use more MAs. While one MA is working in the room with the physician, a second can be rooming the next patient.

This team model has been shown to be more productive, outweighing the additional staffing costs.

The direct primary care model gives family physicians a meaningful alternative to FFS insurance billing, typically by charging patients a monthly, quarterly or annual fee. This fee covers all or most primary care services, including clinical and laboratory services, consultative services, care coordination and comprehensive care management.

In DPC, physicians typically are paid under a monthly membership model. This eliminates most of the administrative tasks inherent to the FFS reimbursement demands of the value-based payment (VBP) model, taking with it the need for much of the EHR documentation, coding and revenue-cycle functions.

DPC benefits patients by providing substantial savings and a greater degree of access to, and time with, physicians.

DPC allows family physicians to care for the whole person while reducing the overhead and negative incentives associated with FFS third-party-payer billing.

Value-based care promises to reduce administrative burdens associated with the FFS model. Shifting to payment centered on value is meant to decrease the volume of visits and the associated administrative complexity inherent to using EHRs.

Unfortunately, too many of the VBP models available to primary care suffer from inadequate FFS payment and poorly designed measurement, which together increase burden on practices.

The VBP models that are working point to what’s possible: population-based prospective payment for high-quality care that allows physicians to achieve the quintuple aim while seeing significant reductions in burden.