7 ways physicians can reduce uncompensated time
Uncompensated time is an unfortunate reality for today’s overwhelmed physicians, the majority of whom (63%) report signs of physician burnout such as emotional exhaustion and depersonalization at least once a week. We’re talking about things like navigating the electronic health record (EHR), assigning medical codes, contacting healthcare payers for prior authorizations, reviewing lab reports, returning patient phone calls, and researching the latest clinical treatments. Clinical documentation is one of the most frequently cited burdensome tasks for which physicians receive no compensation. This is despite the fact that they spend nine hours per week performing it. Time spent on uncompensated tasks was the #2 reason for worsening finances in medical practices last year.
These and other tasks contribute to the steadily increasing administrative burden in healthcare as well as excess healthcare spending. Administrative spending, at least half of which is wasteful, accounts for 15%-30% of all healthcare spending.
The good news is that there are ways to minimize the impact of uncompensated tasks on your medical practice. Here are a few of them:
1. Divide and conquer the work. Physicians can’t—and shouldn’t—take on all of the uncompensated tasks in the medical practice. For example, they can assign a medical assistant to monitor and triage messages through the patient portal so physicians only read and respond to messages that truly require their input. Another example is team-based clinical documentation that can significantly reduce physician burnout. For example, physicians can ask their medical assistant to fully capture the intake, transcribe for the physician during the visit, and complete post-visit documentation tasks. Or they can work with an in-person or virtual scribe to assist with clinical documentation.
2. Leverage the EHR. Concise shortcuts or macros to describe care plans for commonly seen clinical problems can be very helpful. The same is true for customized dashboards or preference lists of frequently ordered tests or labs. Physicians should talk to their EHR vendor about ways to adapt the technology to better meet their needs. For example, an EHR vendor may be able to create a standard visit note template or complete physical exam note template.
3. Enlist patients’ help. Develop standard patient questionnaires to cover the most frequent chief complaints such as diabetes, hypertension, and pain/illness. Patients can complete the healthcare questionnaire online prior to their visit, and their answers automatically populate the history of present illness section of the note. Or rooming staff can pull up the healthcare questionnaires in the exam room so patients can answer them while waiting for their clinician.
4. Use updated office visit evaluation and management (E/M) documentation guidelines. These clinical documentation guidelines, which took effect January 1, 2021, can make a world of a difference in terms of reducing the documentation burden on physicians. Why? They eliminate the need to capture bullet points in the history and exam sections of a clinical note. Physicians can assign an E/M code based on medical decision-making or total time spent with the patient. Fifty-one percent of physicians report a reduction in their clinical documentation burden after implementing the new E/M guidelines. Of these respondents, 68% say it is easier to select a code, and 73% report reduced clinical documentation time.
5. Redesign the visit. The American Academy of Family Physicians (AAFP) suggests finishing notes before the next visit by performing in-room documentation.
6. Shift to value-based payment models. With these models, physicians aren’t paid for each individual service they perform but rather based on their ability to improve healthcare outcomes and reduce healthcare costs. While these models don’t include specific payments for administrative tasks and care coordination, performing these steps may feel less burdensome when reimbursement is tied to quality and cost containment. In the big picture, physicians may feel more adequately compensated for their time.
7. Know what’s actually billable. Half of U.S. states, for example, pay for video, store-and-forward, audio-only telehealth, and remote patient monitoring. In addition, chronic care management is a billable healthcare service that includes payment for care coordination. And when a physician spends longer than expected during an office visit, they may be able to bill for prolonged services. Medical coders can advise physicians around best practices for billing these and other services.
Conclusion
Uncompensated time can be challenging for physicians. However, with the right EHR partner, division of labor, and long-term strategy to shift from fee-for-service to value-based care, medical practices can reduce uncompensated tasks. Learn how edgeMED can help and be sure to check the Healthy Snacks blog for more expert insights, best practices and industry trends.
