Policy Change from the Centers for Medicare and Medicaid Services Provides an Opportunity to Improve Medical Student Education and Recruit Community Preceptors

As U.S. medical educators know, it has been exceedingly difficult over the past decade to train medical students to document in the electronic health record (EHR) yet remain compliant with Centers for Medicare and Medicaid Services (CMS) guidelines. Indeed, some institutions have interpreted the guidelines to prohibit all medical student documentation in the EHR. This has been particularly challenging since the Association of American Medical Colleges has recommended that all medical school graduates be entrusted with 13 specific professional activities, two of which directly require student use of the EHR. Furthermore, critical efforts by clerkship directors to recruit community physicians as preceptors of medical students have been significantly hampered by the medical students' inability to document encounters. Therefore, the CMS policy transmittal Pub 100-04 Medicare Claims Processing Manual, released on February 2, 2018, which now explicitly allows appropriately supervised student documentation to be submitted for billing, is a welcome policy change. U.S. medical educators need to seize this opportunity, encourage their health systems to revise their internal precepting practices, and widely advertise to community preceptors that students can now add value in the clinical setting by assisting with documentation in the EHR.