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Appropriate Use Criteria Archives - Neurosurgery Blog

Cross-Post: Death by 10,000 Clicks: The Electronic Health Record

By Health ReformNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places that we believe will be of interest to our readers. Today’s post originally appeared in MedPage Today on Jan. 21. In the op-ed, neurosurgeons Anthony M. DiGiorgio, DO, MHA, and Praveen V. Mummaneni, MD, MBA discuss the burden of electronic health records (EHR) at their institution, the University of California San Francisco.

Drs. DiGiorgio and Mummaneni audited EHR logs to examine our neurosurgery residents’ work and better understand the benefits and burdens. The results found that on-call residents spent 20 hours logged into the EHR over a single shift. They are detracting from trainees’ educational experience, and health care costs are increasing because of the inefficiencies that come with EHRs.

Drs. DiGiorgio and Mummaneni note that many inefficiencies come from Medicare regulations. For example, the appropriate use criteria program was developed to reduce unnecessary imaging ordered by physicians. Their EHR audit found this added just a few minutes of computer time to the residents’ days. However, there is no evidence that this regulation reduces unnecessary imaging. Many more regulations add a few minutes here and a few minutes there.

Drs. DiGiorgio and Mummaneni state that “it’s death by 10,000 clicks” and urge continued involvement in advocacy to reverse the ever-increasing EHR burden.

Click here to read the full article.

Editor’s Note: We hope you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtag #EHR.

January 26, 2023
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Cross-Post: A Way Forward For The Imaging Appropriate Use Criteria Program: Aligning Quality Metrics

By Cross Post, Health Reform, MedicareNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places when we believe they hit the mark on an issue. Today’s post originally appeared in Health Affairs on Aug. 26, 2021. The article, “A Way Forward For The Imaging Appropriate Use Criteria Program: Aligning Quality Metrics,” discusses proposed changes to the Centers for Medicare & Medicaid Services (CMS) calendar year 2022 proposed Medicare Physician Fee Schedule (PFS) Rule and implementation of the Appropriate Use Criteria (AUC) program. Mandated by the Protecting Access to Medicare Act (PAMA), the AUC program requires physicians ordering advanced diagnostic imaging to consult with AUC using an approved clinical decision support mechanism before the radiologist can provide the scan.

As the Health Affairs piece points out, following the release of the  PFS, the House Appropriations Health Subcommittee included in its report a provision for CMS to inform Congress about the implementation of the AUC program, including any challenges and successes. The AANS and the CNS have urged Congress to repeal the AUC program, given the additional burdens on physicians and potential delays in imaging services. At the very least, the neurosurgical societies have recommended that Congress adopt legislation that directs CMS to incorporate AUC for diagnostic imaging into the existing Quality Payment Program.

Click here to read the full article in Health Affairs.

Editor’s Note: We encourage everyone to join the conversation online by following @Neurosurgery and using the hashtags #Neurosurgery and #Medicare.

September 13, 2021
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