March 01, 2018

CMS-ONC Explore EHR Burden Reduction Options

The Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for Heath IT (ONC) convened a public hearing on February 22, 2018, to explore avenues for burden reduction and ideas related to the clinical use of electronic health record (EHR) technology.

The meeting advanced the implementation of Section 4001 of the 21st Century Cures Act, which requires the Department of Health and Human Services’ (HHS) to consult with health professional societies and other public stakeholders to identify ways to reduce regulatory or administrative burdens specific to EHRs.

CMS representatives highlighted various activities the agency has underway, including:

  • assorted documentation requirement simplification (DRS) initiatives
  • clarifications regarding the use of scribes
  • identification of an open application programming interface (API) for data submission in the Quality Payment Program (QPP) using qualified clinical data registries (QCDRs)
  • development of a user-friendly QPP resource website, and
  • clarifications pertaining to certain signature requirements

Input from public stakeholders focused on:

  • clinical and regulatory documentation misalignment and related burdens
  • EHR-specific workflow interruptions
  • misalignment of CMS programs (e.g., QPP and the Medicare/Medicaid EHR Incentive Program)
  • prior authorization issues—need for automation and transparency
  • disruptive audits for Meaningful Use and other CMS programs
  • EHR versioning/upgrade costs
  • patient-matching problems in lieu of a unique patient identifier, and
  • concerns with the Advancing Care Information (ACI) component of the Merit-based Incentive Payment System (MIPS)

While most public feedback focused on CMS’ programs and regulations, additional concerns were expressed about certain EHR vendors “cheating” ONC’s heath IT certification process and the likelihood of perpetual interoperability/information exchange problems despite relatively widespread EHR adoption.

Radiologists and other stakeholders can submit recommendations for EHR burden reduction in emails addressed to CMS at For more information, see the CMS Reducing Provider Burden website.