ACP: Excessive 'Administrative Tasks' Harm Patient Care

Paperwork, billing, performance measures, regulations, reporting requirements: The American College of Physicians calls these "administrative tasks" a hassle, and calls for a sweeping review.

The American College of Physicians released a position paper Monday calling for the review, revision, and removal of "administrative tasks" they say are cutting into patient care.

Published in the Annals of Internal Medicine, the paper contends that insurance paperwork, government regulations, and performance measures divert physicians' time and focus away from patient care and quality improvement.

It offers recommendation for changes and notes that "an analytic approach to defining and mitigating administrative tasks is critical to addressing them in a more comprehensive, cross-cutting, and holistic manner, rather than fixing one problematic task only to have another arise in its place."

Review
The paper calls for the review of existing regulations and paperwork, the elimination of ineffective requirements, and the justification of new tasks. For example, those who implement administrative tasks should "provide financial, time, and quality of care impact statements for public review and comment."

Tasks that have "a negative effect on quality and patient care, that unnecessarily question the judgment of physicians and other clinicians, and/or that increase costs should be challenged, revised, or removed entirely," it says.

Clinicians and staff spend about three to five hours on billing and insurance administration and up to fifteen hours on quality measurement and reporting, according to a literature review by the authors.

They also cited studies concluding that the cost of dealing with administrative tasks was 12% to 14% of physician revenue, or about $68,000 to $85,000 per physician.

Revise
The paper further calls for regular, transparent revision of any administrative tasks that cannot be eliminated. Specialty societies, clinicians, patients, and HIT vendors should "aim for performance measures that minimize unnecessary clinician burden" and integrate performance measurement into quality improvement programs.

The authors note that their recommendations are important as the healthcare system moves toward value-based payment.

Finally, they call for "meaningful collaboration to improve the development, testing, and implementation of measures and to ensure that health IT is used innovatively to streamline processes and reduce burden."

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ACP: Patients Before Paperwork

LINK: Putting Patients First by Reducing Administrative Tasks in Health Care