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The burden of clinical documentation on professionals, such as work done in the EHR, has had a proven negative impact on health care. This burden leads to a variety of negative outcomes including clinician burnout and decreased job satisfaction, increased medical errors and hospital-acquired conditions.

In December 2021, AMIA assumed leadership responsibility for the 25x5 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 25x5 Symposium.

News & Updates

December 7, 2022

AMIA and Pacesetters Comprehensively Tackle Burden Reduction in Healthcare

Read the press release

August 2022

In May, U.S. Surgeon General Vivek Murthy, MD, MBA, issued an advisory to combat physician burnout, and referenced the 25x5 Symposium report.

In response to the report, AMIA identified 10 Actions for Healthcare Organizations.

Calls to Action

  • Establish guiding principles for adding documentation to the EHR and generating evidence for reduced documentation
  • Develop a national roadshow and educate clinicians and clinicians in training on balancing brevity and completeness in documentation
  • Support functions like real-time information retrieval, documentation, and ordering
  • Implement interdisciplinary notes

  • Promote an ecosystem of interoperable systems to allow for complementary technology
  • Develop metrics to review and grade a user’s documentation
  • Package best training practices into toolkits to promote “best practice” EHR use and plan recognition programs to publicize exemplars
  • Create simplistic EHR views to see that new clinical data has been reviewed-then bookmark for the user and document as reviewed by that user in the EHR
  • Implement personalized Clinical decision support (CDS) to drive user-specific workflows

  • Urge agencies to fund research that captures billing code information without engaging clinician time
  • Select the best of breed and implement throughout the healthcare system
  • Develop technology to reliably and accurately create reimbursement/payment data for all care setting

Task Force

Chaired by Sarah Rossetti, RN, PhD, FACMI, FAMIA AMIA, the 25x5 Task Force and 25x5 student subcommittee held a kickoff meeting on April 14, 2022. The task force membership is structured around three workstreams:

  • Providers/Health Systems
  • Health IT vendors
  • Policy/Advocacy

Task Force Mission

Reduce documentation burden for U.S. Clinicians to 25% of current state in the next five years1 and optimize electronic health record (EHR) and related vendor solutions by prioritizing and implementing the 25x5 Symposium Calls to Action/Recommendations2  through partnerships and advocacy with health systems, professional societies, and public/private sector organizations in order to spread these solutions across the U.S. health system.

To accomplish the mission, each workstream has developed short-term work plans with goals and milestones that are achievable this year and are currently developing robust longer-term workplans for action within five years.

Short-term Work Plan

Providers/Health Systems Workstream

The Providers/Health Systems workstream is creating a toolkit to guide organizations through the process of reducing documentation burden. The toolkit is intended to provide resources related to governance of EHR optimization, implementation of solutions to reduce burden, and approaches to measure burden reduction.

The Provider/Health System workstream is also working toward the creation of a national learning collaborative to bring providers and health systems together to identify and share effective interventions and establish a mechanism to pilot and measure success of new interventions.

Health IT Vendors Workstream  

The Health IT Vendors workstream is partnering with vendors to educate current EHR users about existing functionality, tools and services that can streamline data entry and reduce the length of documentation making it easier for clinicians to identify important information within the record. EHR and non-EHR IT vendors are being asked to aggregate and synthesize training materials that show how to avoid over documentation and more efficiently document only what is necessary. Vendors are identifying existing clients in ambulatory setting willing to participate in the intervention.    

The Health IT Vendors workstream is also building a five-year roadmap of HIT initiatives to reduce documentation burden. While there are a wealth of ideas and efforts within the HIT community to reduce documentation burden, many of these do not achieve their full potential due to challenges in changing dominant documentation practices in place today and structural barriers, such as interoperability. The workstream is seeking concrete ideas from the broader health care community that are aligned to the 25x5 priorities for inclusion on the roadmap. 

25x5 Finalists

The AMIA 25x5 Task Force would like to thank everyone who submitted a pitch for sharing their ideas, innovations and current capabilities aimed to reduce documentation burden.

Policy/Advocacy Workstream

The Policy/Advocacy workstream is conducting an environmental scan of existing efforts to reduce documentation burden and meeting with regulatory and accreditation groups to identify areas to support or expand upon, avoid duplicative efforts, and identify any current gaps. A policy brief is anticipated in early 2023. Additionally, the workstream will support the initiatives of the other two workstreams through policy and advocacy efforts.


Adoption of 25x5 is the culmination of a series of thought-leadership activities driven by AMIA members to acknowledge and respond to the emergent crisis. Columbia University, Vanderbilt University, and the American Medical Informatics Association (AMIA), through support from the National Library of Medicine (NLM), convened the 25x5 Symposium of decision-makers and influencers representing clinical settings, academia, industry, government, payers, professional organizations, and patients to establish strategies and approaches to reduce documentation burden on U.S. clinicians by 75%.

The symposium series included more than 30 presentations from stakeholders across healthcare ecosystem. The Final Summary Report and Executive Summary describing this work includes current challenges, exemplars, and 82 specific calls to action describe in detail.

The 82 action items were then further synthesized and prioritized into Calls to Action for three stakeholder groups: Providers and Health Systems, Vendors, and Policy and Advocacy.


1 5-year period of 1/1/2022-12/31/2026​

2 Calls to Action (page 21-22) and recommendations (page 25-26) from the 25x5 Symposium Final Summary Report

Stay Up-to-date

If you or your organization would like to learn more and/or participate in the AMIA 25x5 initiative, please reach out to Katy Sidwell.

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25x5 Community

Open to everyone

Join the AMIA 25x5: Reducing Documentation Burden Connect community on AMIA Connect to network, collaborate and share information on this critical initiative.

Nonmembers will need to create an AMIA account in order to access the community.

Join the 25x5 community