Appl Clin Inform 2022; 13(02): 439-446
DOI: 10.1055/s-0042-1746169
CIC 2021

25 × 5 Symposium to Reduce Documentation Burden: Report-out and Call for Action

Mollie Hobensack
1   Columbia University School of Nursing, New York, New York, United States
Deborah R. Levy
2   Oregon Health and Science University, Portland, Oregon, United States
Kenrick Cato
1   Columbia University School of Nursing, New York, New York, United States
3   Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, United States
Don E. Detmer
4   Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, United States
Kevin B. Johnson
5   University of Pennsylvania, Philadelphia, Pennsylvania, United States
Jeffrey Williamson
6   American Medical Informatics Association, Bethesda, Maryland, United States
Judy Murphy
7   Minneapolis, Minnesota, United States
Amanda Moy
8   Department of Biomedical Informatics, Columbia University, New York, New York, United States
Jennifer Withall
1   Columbia University School of Nursing, New York, New York, United States
Rachel Lee
1   Columbia University School of Nursing, New York, New York, United States
Sarah Collins Rossetti
1   Columbia University School of Nursing, New York, New York, United States
8   Department of Biomedical Informatics, Columbia University, New York, New York, United States
Samuel Trent Rosenbloom
9   Departments of Biomedical Informatics Internal Medicine and Pediatrics, Vanderbilt University, Nashville, Tennessee, United States
› Author Affiliations
Funding The Symposium was supported through the 1R13LM013581 grant funded by the NLM and co-sponsored by AMIA. The co-authors are also supported through training grants from the NLM (5T15LM007079) and the National Institute of Nursing Research (5T32NR007969).


Background The widespread adoption of electronic health records and a simultaneous increase in regulatory demands have led to an acceleration of documentation requirements among clinicians. The corresponding burden from documentation requirements is a central contributor to clinician burnout and can lead to an increased risk of suboptimal patient care.

Objective To address the problem of documentation burden, the 25 by 5: Symposium to Reduce Documentation Burden on United States Clinicians by 75% by 2025 (Symposium) was organized to provide a forum for experts to discuss the current state of documentation burden and to identify specific actions aimed at dramatically reducing documentation burden for clinicians.

Methods The Symposium consisted of six weekly sessions with 33 presentations. The first four sessions included panel presentations discussing the challenges related to documentation burden. The final two sessions consisted of breakout groups aimed at engaging attendees in establishing interventions for reducing clinical documentation burden. Steering Committee members analyzed notes from each breakout group to develop a list of action items.

Results The Steering Committee synthesized and prioritized 82 action items into Calls to Action among three stakeholder groups: Providers and Health Systems, Vendors, and Policy and Advocacy Groups. Action items were then categorized into as short-, medium-, or long-term goals. Themes that emerged from the breakout groups' notes include the following: accountability, evidence is critical, education and training, innovation of technology, and other miscellaneous goals (e.g., vendors will improve shared knowledge databases).

Conclusion The Symposium successfully generated a list of interventions for short-, medium-, and long-term timeframes as a launching point to address documentation burden in explicit action-oriented ways. Addressing interventions to reduce undue documentation burden placed on clinicians will necessitate collaboration among all stakeholders.

Protection of Human and Animal Subjects

This work was reviewed by the Institutional Review Board and concluded it was not human subjects' research.

Publication History

Received: 15 December 2021

Accepted: 28 February 2022

Article published online:
11 May 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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