Electronic Health Records

ACEP and VACEP are working to lower your administrative burden

Everyone who works in health care knows electronic health records (EHRs), originally designed to streamline patient records and improve patient care, have dramatically increased the amount of time providers are spending mired in paperless “paperwork.” It’s an industry-wide concern leading to increased burnout and job dissatisfaction, and recent surveys of ACEP membership revealed that no matter your age, years of experience, or clinical setting, EHR frustration and overall “administrative burden” is your #1 pain point.

It’s a complicated issue affected by many different entities and regulations, so our advocacy team is working in multiple channels to push for positive progress. The following is an overview of ACEP’s efforts.

For more information, including policy statements, smart phrases, information papers and regulations, visit the American College of Emergency Physicians website.

Appropriate Use Criteria (AUC) Program

Created in legislation in 2014, the AUC program will eventually require physicians ordering advanced imaging for Medicare beneficiaries to first consult AUC through approved clinical decision support mechanisms in order for the furnishing provider to be able to receive payment. While the requirement does not start until 2020, we have heard hospitals are already forcing emergency physicians to consult AUC before ordering advance imaging. We’re hearing these AUC tools are burdensome and not user-friendly, and often do not apply to the cases typically seen in the emergency department. We’ve fought hard to get all emergency physicians exempted from the AUC program requirements, and we recently achieved a significant victory that saves you unnecessary administrative hassle.

Our stance: The underlying legislation creating the AUC Program exempts emergency services defined as an “applicable imaging service ordered for an individual with an emergency medical condition” from the requirements. As a result of our advocacy, CMS clarified that this exemption includes cases where an emergency medical condition is suspected, but not yet confirmed. In other words, if you think your patient is having a medical emergency (even if he/she winds up not having one), you are excluded from the AUC requirements in that particular case.

What it means for EM physicians: This clarification is HUGE for us. Requiring you to consult AUC in potential emergency situations would have put patients’ lives at risk. Seconds matter in these cases, and you don’t have time to consult AUC tools that may not even be applicable to your patients. With this clarification, you can move quickly to treat patients who may have an emergency medical condition.

How you can take action: Now that we have this clarification to the exemption, we need you to spread the word to your hospital administrators. We drafted a sample letter you can use to let your hospital administrators know about the emergency medical condition exemption and ask them to help make sure the exemption is properly implemented in your emergency department.