TMA Calls on Federal Agencies to Reduce Physicians’ Tech Burdens
By Alisa Pierce

Answering a federal call for input, the Texas Medical Association called for comprehensive changes to the nation’s health technology infrastructure, including solutions for the 58% of Texas physicians negatively impacted by electronic health record (EHR) usability issues. 

 The Centers for Medicare and Medicaid Services (CMS) and Assistant Secretary for Technology Policy (ASTP)/the Office of the National Coordinator for Health Information Technology (ONC) began seeking public comment in May to inform their ongoing efforts in advancing data exchange among payers, health care practices, and patients, the agencies say. 

In response, TMA submitted several recommendations calling for widespread improvements across health information technology (HIT), including those that: 

• Promote strong interoperability standards; 

• Simplify data entry requirements to reduce physicians’ administrative burden;  

• Address growing technology requirements placed upon small and rural practices; and 

• Improve EHRs and other digital tools to make them more user-friendly. 

Philip Bernard, MD, chair of TMA’s Committee on HIT and Augmented Intelligence, says TMA’s reply was just one of several efforts the association has made in recent years to address technology limitations that place undue burden on physician practices.  

“This was an opportunity for TMA to highlight where more work can be done,” the Dallas pediatrician said. 

Optimizing the EHR 

Likewise, TMA expressed frustration EHR usability remains inconsistent for physicians and often fails to streamline care as intended, increasing physicians’ workload and impacting patient care as a result. 

TMA recommended CMS and ASTP/ONC work to enhance EHRs by supporting the development of systems that feature interfaces and tools aimed at decreasing physicians’ screen time. Moreover, TMA called on CMS to require EHRs to track and report the amount of time physicians spend on inbox management, recognizing physicians should be compensated for extra work. 

TMA also recommended the federal agencies improve physicians’ electronic workflow by: 

• Developing a standardized, consumer-controlled personal health record that can collect and organize data from CMS, physician practices, health care organizations, payers, and third-party apps; 

• Creating separate campaigns to promote digital health products that can interface with EHRs, rather than holding physicians responsible or liable for recommending those products to their patients; 

• Removing the burden of ever-changing and “insufficiently tested” quality improvement requirements, which often create additional complexities that detract from patient care and safety; and 

• Revive the national Health IT Extension Program to support rural and small practices in implementing and maintaining certified HIT. 

“TMA continues to advocate for physicians so the technology used in the practice setting provides the right information, at the right moment, for the right patient, allowing physicians to make the right decision for the best possible clinical outcome,” TMA stated. 

Improving interoperability

TMA stressed interoperability efforts aiming to improve care efficiency have done the opposite: Rather than having information network standards in place to focus the flow of incoming data on what’s needed, relevant, and appropriate at the point of care, physicians are left responsible to make sense of all incoming data. 

“Interoperability isn’t just about creating the ‘pipes’ to move data. It’s also not just programming computers to ‘read’ what is received,” TMA stated. “Equally important is the relevance and usability of the data received.” 

To ensure health care data remains appropriate and easily accessible for physician practices, TMA called on CMS and ASTP/ONC to support a universal standard of exchanging health information. TMA argued, for example, comprehensive encoding of data – like using a standardized list of codes across all health systems and EHRs – would allow information to be searchable, easily extracted for reports, and available for clinical decision support. 

Clinical decision support tools in EHRs rely on data encoding to function. Only 24% of Texas physicians find those tools helpful, with many citing irrelevant information and alert fatigue as issues, per TMA’s 2025 HIT Survey.  

Furthermore, TMA asked CMS and ASTP/ONC to develop standardized pathways to report technology issues and opportunities for improvement, especially if patient safety is at risk. TMA added CMS should consider requiring certified technology vendors to create such pathways with minimal effort placed on the physician.  

TMA also pressed CMS and ASTP/ONC to follow Texas’ hard-won example and authorize an exception to the immediate release of certain sensitive tests – like a cancer diagnosis – to allow clinicians at least three business days to relay the results to the patient. Additionally, TMA stated certified EHR products should have a standardized way for physicians to hold test results, so those results are not automatically pushed to the portal when received by the practice.  

“Cancer-related test results can be confusing, scary, and life-changing. Physicians are trained to convey such information in a timely, informative, and supportive manner, so patients understand not only what the test means, but also what options they have,” TMA stated. 

For a comprehensive look into TMA’s ongoing federal advocacy efforts, see the association’s comment letters.