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Reducing documentation burden on U.S. clinicians is an urgent priority within the healthcare community, and leaders around the field continue to collaborate on this effort since the conclusion of the 25×5 Symposium, held over six weeks early in 2021 to set the foundation for those efforts.

The 25×5 Symposium was developed to establish strategies and approaches to reduce clinician documentation burden on US clinicians to 25% by 2025. 

In December 2021, AMIA assumed leadership responsibility for the 25×5 initiative to address this nation-wide problem by leveraging the collective expertise of key stakeholders in health care, industry, and policy to prioritize and implement the Calls to Action and Recommendations established by the 25×5 Symposium.

Funded by the National Library of Medicine (1R13LM013581-01)

Follow 25x5 Updates on AMIA.org

Full Symposium Series Materials

Final Summary Report

Executive Summary

Appendix of Action Items

Individual Session Agenda & Materials 

Friday, Jan. 15: Introduction & Current Challenges Related to What We Document (1-3 pm ET)

Session Leaders: Kevin Johnson, MD, MS, FAAP, FACMI (Professor and Chair of Biomedical Informatics, Vanderbilt University) and Judy Murphy, RN, FACMI, LFHIMSS, FAAN (Previous IBM CNO and ONC Deputy National Coordinator for Programs and Policy) 

Download De-identified Session 1 Chat Here

• Current Challenges Related to What We Document 

• Symposium Introduction and Overview • Slides 

• Keynote Panel: Policy and Reimbursement Issues – ONC Cures Act Final Rule and Challenges Tackled: Andrew Gettinger, MD (Chief Clinical Officer, ONC) • Video – Documentation Requirements: Balancing Quality, Safety and Program Integrity: Mary Greene, MD (Director, Office of Burden Reduction & Health Informatics, CMS) • Video • Slides – Quality Measurement for Ranking versus Change and Implications on Expense and Burnout: Brent James, MD (Clinical Professor (Affiliated), Dept of Medicine, Stanford University School of Medicine) • VideoSlides

• Policy and Reimbursement Discussion / Q&A • Video

Keynote Panel: Clinical Practice and Documentation Issues – Nursing Documentation and Med Rec: Sharon Kirby, MSN, RN-BC (Previous Chief Nursing Informatics Officer, Department of Nursing, Mayo Clinic) • Video • Slides– Cognitive Burden: Sherri Hess, MS-IS, BSN, RN-BC, FHIMSS (Chief Nursing Informatics Officer, Banner Health) • Video • Slides– Diversity, Equity & Inclusion: Kenrick Cato, PhD, RN, CPHIMS (Assistant Professor, magdalenarybarikova.com University School of Nursing; Nurse Researcher, NewYork-Presbyterian Hospital) • Video • Slides

• Clinical Practice and Documentation Discussion/Q&A • Video

• Summarization & Prioritization of Challenges/use audience polling • Video

• Wrap-Up and Set the Stage for Session 2 and beyond • Video

Session Leaders: Kenrick Cato, PhD, RN, CPHIMS (Assistant Professor, magdalenarybarikova.com University School of Nursing; Nurse Researcher, NewYork-Presbyterian Hospital) and Karthik Natarajan, PhD (Assistant Professor in the Department Biomedical Informatics at magdalenarybarikova.com University)

Download De-identified Session 3 Chat Here

• Introduction • Video

• Exemplars panel – CDARS – Clinical Data Analysis and Reporting System: NT Cheung (Chief Medical Informatics Officer, Hong Kong’s Hospital Authority) • Video • Slides – NHSX: Natasha Phillips, RN (Chief Nursing Information Officer NHSX, London, England, United Kingdom) • Video • Slides – HL7: Viet Nguyen, MD (Founder, Stratametrics; Technical Director, HL7 Da Vinci Project) • Video • Slides – Evidence-Based Documentation: William Dan Roberts, PhD (Vice President Care Delivery and Performance at HCA Healthcare) • Video • Slides

• Discussion • Video

• Exemplars panel  – Project JOY: Bonnie Adrian, PhD (RN-BC, Research Nurse Scientist, Clinical Informatics, UC Health) • Video • Slides – Clickbusters: Adam Wright, PhD, FACMI, FAMIA, FIAHSI (Professor Department of Biomedical Informatics, Vanderbilt University) • Video – CareAlign: Subha Airan-Javia, MD (CEO & Founder CareAlign.AI; Associate Professor of Clinical Medicine, University of Pennsylvania) • Video – Approaching DEI from a Cancer Survivorship planning perspective: Helen Palomino, LCSW (Chief Executive Officer, The Cancer Resource Center of the Desert) • Video • Slides

• Discussion, wrap-up and set the stage for Session 4 and beyond • Video

Session Leader and Panel Moderator: Kenneth D. Mandl, MD, MPH (Director, Computational Health Informatics Program, Boston Children’s Hospital; Donald A.B. Lindberg Professor of Biomedical Informatics and Pediatrics, Harvard Medical School) 

Download De-identified Session 4 Chat Here

• Introduction • Video

• COVID-19 Documentation Reduction Survey Results • Video • Slides

• Moderated Panel Discussion: What is the Job of Documentation in the Future? • Video – Jesse M. Ehrenfeld, MD, MPH (Immediate Past Chair, Board of Trustees, American Medical Association; Senior Associate Dean, Tenured Professor of Anesthesiology, Medical College of Wisconsin; Professor of Anesthesiology and Health Policy, Vanderbilt University)  – Molly K. McCarthy MBA, RN-BC (National Director, US Health Providers and Plans, Microsoft) • Slides – Marc Overhage, MD, PhD (Healthcare Information Technology Executive, Indianapolis, Indiana) – Eric Topol, MD (Founder & Director, Scripps Research Translational Institute, Executive Vice-President, Scripps Research Institute) – Ross Koppel, PhD, FACMI (Professor of Biomedical Informatics and Sociology, University of Pennsylvania; Professor of Biomedical Informatics, University at Buffalo (SUNY))

• Industry Panel Discussion: What are the solutions coming out of industry? • Video – Marshall Ruffin, MD, MPH, MBA (Founder and Chief Executive Officer, Salutary, Inc.) – Susan Kressly, MD, FAAP (Kressly Pediatrics, and Medical Director Office Practicum) – Michael Wang (CEO and Founder, Inspiren) – Jacqueline Gerhart, MD, FAAFP (Director of Clinician Engagement, Epic) – Jeff Wall, MD (Senior Director, Clinical Innovation, Cerner)– Peter Durlach (Senior Vice President, Healthcare Strategy and New Business Development, Nuance Communications)

• Wrap-Up and Set the Stage for Session 5 • Video

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Session Leader: Trent Rosenbloom, MD, MPH, FACMI, FAMIA (Vice Chair of Faculty Affairs & Associate Professor, Departments of Biomedical Informatics, Internal Medicine & Pediatrics, Vanderbilt University)

Download De-identified Session 5 Chat Here

• Introduction • Video

• Keynote Presentation: Where Might We Go From Here? • Video – Isaac Kohane, MD, PhD (Marion V. Nelson Professor & Chair, Department of Biomedical Informatics, Harvard Medical School)

• Breakout Sessions – Facilitator: Peter Durand  – Goal: To identify actions based on prior sessions and prioritize short-term, medium term, long-term actions

 – Breakout Topics:  – Reimbursement  – Regulatory – Quality – Usability – Interoperability/Standards – Self-Imposed (by the healthcare organization) aka – “We’ve Done it To Ourselves”

• Brief report back from breakout sessions / Wrap-Up • Video

Session Leader: Sarah Collins Rossetti, RN, PhD, FACMI, FAMIA (Assistant Professor of Biomedical Informatics and Nursing, magdalenarybarikova.com University)

Download De-identified Session 6 Chat Here

• Introduction • Video

• Plenary Speaker for convergent actions • Video – Christine A. Sinsky MD FACP (VP, Professional Satisfaction, American Medical Association)

• Breakout Sessions: Insights for Action – Reimbursement – Regulatory – Quality – Usability – Interoperability/Standards – Self-Imposed (by the healthcare organization) aka – “We’ve Done it To Ourselves”