The Centers for Medicare and Medicaid Services is committed to reducing the regulatory burden on providers with several new initiatives as part of the Trump administration’s broader efforts to cut red tape in the federal government, according to CMS Administrator Seema Verma.
“One of the things that we know that is impeding patient care is the regulatory burden,” said Verma, who spoke Friday at the Office of the National Coordinator for Health IT’s annual meeting in Washington.
According to Verma, CMS is one of the top agencies in terms of the volume of regulations it generates—11,000 pages every year, and she contends that “too much regulation can have a suffocating effect on the healthcare delivery system.”
In particular, Verma claims that providers are spending a lot of their time on administrative tasks because physicians are staring at their computer screens and entering data, which is distracting them from patient care.
“Across the board we’re taking a hard look at the regulations that we’re putting out,” said the CMS chief.
In October, CMS launched the Patients Over Paperwork initiative to reduce regulatory burdens on providers to enable them to spend more time on clinical tasks. That same month, the agency announced the Meaningful Measures initiative, which it intends to be a new approach to quality measurement and to streamline current measure sets, moving from process measures to a focus on outcome-based measures going forward.
“The requirements around reporting, around measurement is something that we’re hearing about across the board, and this is creating tremendous burden for our providers,” Verma said. “We’re working towards trying to consolidate a lot of the measurement, trying to make sure that they align across the system.”
She also noted that electronic health record systems do not lend themselves easily to report measures back to CMS. According to Verma, one hospital complained to her that they had to hire 18 people to extract measures manually because it was impossible to get the data out of their EHR to comply with the agency’s reporting requirements.
“We’ve got to get the technology to come in parallel with where we want to go,” she added.
While Verma acknowledged that health IT has for the most part benefitted healthcare, she observed that the problem with some EHRs is that they were designed as “billing systems” rather than as platforms to accommodate patient workflows.
When it comes to the lack of EHR interoperability, Verma related how she personally witnessed the limitations of electronic health information sharing when her husband—a doctor—went into cardiac arrest in August while at an out-of-state airport.
After undergoing tests at the Hospital of the University of Pennsylvania, Verma’s husband was released, but before they left the facility to go back to their home in Indiana, she asked the hospital for a copy of her husband’s medical records and test results to take back to his physician.
“The room got really quiet and they kind of looked at each other and it was like—‘We have no idea what to do here,’ ” recounted Verma. “Ultimately, I left the hospital with five sheets of paper and a CD-ROM.”
However, she noted that while the paper included a discharge summary with her husband’s diagnosis, “what I did not leave with were all the other tests” that he had, including an MRI and CT scan.
“If something in the future is an issue, it would be nice to have those tests available,” added Verma, who said achieving interoperability is critical. “That data should be our data. That’s our information, and the patient should have that.”
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