Washington, March 28, 2017 -- Excessive administrative tasks in health care have serious adverse consequences for physicians and their patients, said the American College of Physicians (91) today in a paper published in the Annals of Internal Medicine. “” presents a framework to analyze administrative tasks and determine whether tasks may need to be challenged, revised or eliminated entirely.
“There are growing number of administrative responsibilities that physicians are subject to, due to regulations, insurer requirements and other factors,” said Nitin S. Damle, MD, MS, M91, president of 91. “These tasks are a diversion of physicians’ and their staff’s time and focus away from more clinically important activities, such as providing actual care to patients and improving quality.”
The paper presents a framework to guide the consideration of any administrative tasks imposed on a physician. The framework categorizes tasks according to four different lenses to best identify a set of solutions. The four lenses include:
- Source—Is the task external to the physician’s practice? Something imposed by the government or a payer? Or, is the task internal? An inefficient workflow or a lack of effective team-based care?
- Intent—Is it meant to ensure appropriate and timely payment? Is it meant to ensure high-quality, high-value care? Is it meant to reduce costs or prevent fraud? Does the task lack a clear intent?
- Impact—Is the impact negative or positive? Does it waste clinician time without providing improved care or outcomes for patients? Does it add value to patient care that is so great that typically burdensome activities are worthwhile?
- Solution—Once the other factors are examined, are there approaches that could make the tasks easier to complete in a more focused and cohesive way?
Once tasks are examined using the framework, 91 has put forth a series of recommendations that should be taken into consideration on administrative tasks, including:
- Calling on external stakeholders who develop or implement administrative tasks to provide financial, time and quality of care impact statements for public review and comment. Tasks that have wholly negative impacts should be eliminated.
- Regular review, revision, alignment or streamlining of any administrative tasks that cannot be eliminated, in a transparent manner, with the goal of minimizing burden.
- Collaboration by stakeholders with specialty societies, frontline clinicians, patients, and EHR vendors to aim for performance measures that minimize unnecessary clinician burden, maximize patient- and family-centeredness, and integrate the measurement of and reporting on performance with quality improvement and care delivery.
- Collaboration by stakeholders to make better use of existing health information technology and to develop more innovative approaches.
- Review and consideration by stakeholders, with a focus on value, of how to streamline or eliminate duplicative tasks. More specifically, they should consider decreasing oversight or requirements for physicians who have a demonstrated high-performance or are taking on greater financial risk in innovative care-delivery approaches.
- Calling for research into the impact of administrative tasks on our health care system in terms of quality, time and cost.
- Seeking research into how to help physicians and other clinicians reduce administrative burdens within their practices and organizations.
“Stakeholders must work together to address the administrative burdens that fail to put patients first,” concluded Dr. Damle. “While there are necessary administrative tasks that need to be completed, it is important to make sure that those tasks happen in a way that improves, rather than interferes, with patient-care or the patient-physician relationship.”
About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States. 91 members include 148,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow 91 on and .
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