A new Administrative Simplification resource library from the AAFP offers solutions for eliminating or reducing administrative burdens in areas including documentation, prior authorization, and the electronic health record (EHR) inbox, as well as updates on the Academy’s progress in achieving administrative simplification through its federal and state advocacy efforts.
The library is available at https://aafp.org/simplify
Documentation Burden
For every aspect of documentation burden, the AAFP offers innovations—techniques, technologies, and transformations—to help family physicians change their practice environment. Each provides an overview of documentation burden, describes its impact on family physicians, and discusses solutions that can provide relief.
Family physicians who want to begin tackling burden by making modest changes can adopt practical techniques that optimize current processes and workflows. The library offers tips for redesigning patient visits, for example, that can be readily implemented in virtually any family medicine practice. It also includes recommendations for optimizing EHRs to reduce the number of clicks it takes to perform simple operations, as well as guidance on using the 2021 outpatient and office visit evaluation and management coding changes to cut burden.
Those who choose to utilize an innovative technology or service that offers promise in reducing or even eliminating documentation burden will find a number of options. These include scribes and scribing services; speech recognition tools; and artificial intelligence (AI)–powered, voice-enabled digital assistants. The library outlines the pros and cons of each option and includes monthly pricing estimates for each. Resources also help family physicians review the impact that each of these technological innovations has on factors such as time saved, burden reduction, and increased efficiency and satisfaction.
Family physicians who are ready to dig in and change processes can learn about organizational changes a practice can make to modify its workflow and operations. Transformations to improve documentation burden range from expanding nonphysician clinicians’ scope of work to adopting new practice models.
Prior Authorization Burden
AAFP members consistently characterize prior authorization as among the most demanding administrative burdens they and their staff deal with every day. Moreover, they say, prior authorization requirements are continually increasing, stealing time from patient care and, ultimately, hurting the bottom line.
The library offers techniques to help successfully navigate those requirements, categorized into 3 primary areas.
The first of these is to prescribe mindfully. After all, avoiding prior authorizations in the first place, such as by choosing generic medications rather than costlier brand-name drugs when possible, prevents associated downstream burdens.
Delegating prior authorization duties to designated staff and streamlining workflows also can significantly lower burden posed by prior authorizations.
EHR Inbox Burden
Some of the techniques used to address the burdens described above likewise apply to taming EHR inboxes. Delegation, for example, can play a huge role in reducing the number of EHR messages physicians need to handle themselves. For starters, information technology (IT) departments may be able to route incoming messages to a designated individual, such as a nurse or medical assistant (MA). Physicians also can collaborate with staff to identify the most appropriate person or people to review incoming messages and route them appropriately.
The resource library helps physicians build on that process by designating staff members to perform certain tasks associated with incoming e-mail, such as filling out disability or physical exam forms. They may not be able to complete the entire document, but they can get the process rolling and save time.
Those who do plan to delegate inbox tasks to staff should create protocols for them to follow when needed. Establishing standing orders for handling urgent and emergent messages and medication refills, as well as templates for communicating test results, ensures they don’t fall through the cracks. On a related note, setting aside time each day to review inbox items and forward them for staff to act on before they leave can keep physicians from being stuck with a backlog of messages that easily could have been handled.
Of course, precluding the need for messages to reach physicians’ inbox in the first place is guaranteed to winnow down volume. Tactics such as ensuring the patient has enough medication to last until the next appointment and timing laboratory orders so results can be discussed at that visit can help. An AMA toolkit highlighted in the library offers more inbox management tips.
Finally, although the technological options to address EHR inbox burden are limited, 2 promising technologies stand out: unified communications platforms and AI assistants. The library offers real-world examples.
More to Come
The library is a work in progress, with more administrative simplification resources being developed, including remedies for burden posed by quality measurement requirements, chart review demands, payment, and more.
- © 2023 Annals of Family Medicine, Inc.