Is a Payment System that Rewards Outcomes the Key to Reducing EHR Burden?

​The key to overcoming the counterproductive effects of electronic health record (EHR) systems may be changing the physician payment structure, argues the author of a perspective published May 25, 2017, in the New England Journal of Medicine. Switching to an EHR payment model that rewards outcomes instead of processes could help restore "meaning" to patient care, the author says. At a time when paying for value over volume has become a point of policy, the author notes, ironically EHRs continue to be mostly fee for service. EHRs are well suited for process-based payments because they include detailed, easily audited pieces of information. "The more detailed the documentation of process, the greater the opportunity for reimbursement," the author says. He describes an "electronic arms race" between payers, who demand increasingly detailed documentation, and vendors, who respond with elaborate ways to document EHR use.