Attend to EHRs so we can attend to patients, physicians say

AMA Wire
Email this page

The burden of meaningful use regulations and the associated problems with electronic health record (EHR) technology has plagued physicians for far too long. At the 2015 AMA Interim Meeting, physicians took action with the goal of removing these hindrances to physicians’ ability to provide quality care to patients.

EHR interoperability is crucial to certification

Policy was adopted concerning shortcomings in EHR interoperability. The meaningful use program offers powerful financial incentives and disincentives for physicians but does not do so for EHR vendors. Meanwhile, most EHR systems fail to satisfy physician users.

Additionally, some hospitals are requiring physicians to use specific brands of EHRs when those physicians already have invested in other EHR products. The fact that a lot of these different products do not work together has put many physicians in a financial bind. Should they purchase two EHR products? Three? Being able to share patient information and data seamlessly should be possible across EHR products.

Physicians called for the Office of the National Coordinator for Health IT (ONC) to prioritize EHR interoperability, data portability and health IT data exchange testing.

The AMA will work with EHR vendors to promote transparency of actual costs of EHR implementation, and CMS and ONC to identify barriers and solutions to data blocking so that physicians and hospitals have more options for purchasing, donating, subsidizing or migrating to new EHRs.

New policy also asks that the AMA:

  • Submit a report to the Department of Health and Human Services (HHS), the ONC and CMS concerning shortcomings in EHR interoperability, placing special emphasis on requiring vendors to provide systems that comply with interoperability standards as a basic requirement for certification. 
  • Insist that hospitals and health systems be prevented from requiring specific brands of EHRs for affiliated but independent physicians.
  • Advocate that sponsoring institutions providing EHRs to physician practices provide data access to physicians if they withdraw support of EHR sponsorship.

Information should be shared, not blocked

In the wake of the administration’s decision to move ahead with implementation of Stage 3 of the meaningful use program despite widespread failure of Stage 2, the AMA has taken action with urgency.

In letters sent earlier this month to both the U.S. House of Representatives (log in) and the Senate (log in), the AMA and 110 other medical societies noted that what has emerged from the administration is a “morass of regulation” for a program that has “failed to focus on interoperability and has instead created new barriers to easily exchange data and information across care settings.”

Specific to meaningful use, physicians reaffirmed AMA policies that seek revisions to quality standards and meaningful use requirements to make them more streamlined, usable and less burdensome, and the development of a one-portal, one username and password system to align all processes.

AMA Immediate-Past Chair Barbara L. McAneny, MD, noted in a news release that “action will be needed to refocus the goals of the meaningful use program on promoting better coordinated and high-quality patient care.”

Physicians also adopted policy to call on Congress to “introduce legislation to eliminate unjustified information blocking  and excessive costs which prevent data exchange.”

The policy insists that any clinician who has previously attested for meaningful use not be penalized if EHR technology is decertified as a result of stricter certification requirements.

The policy also strongly reiterates the need to continue efforts to prevent expansion of meaningful use and other programs until EHR interoperability is accomplished.

Until the job is done

Advocating on behalf of physicians and patients to relieve EHR woes continues to be a priority for the AMA. At two recent AMA town hall meetings on EHRs—the first in Atlanta and second in Boston—physicians convened to share publicly how burdensome EHRs and the regulations surrounding them have become.

Recently, the AMA and MedStar Health’s Center for Human Factors in Healthcare developed an EHR User-Centered Design Evaluation Framework and found that the top 20 EHR products didn’t measure up to user-centered recommendations.

The AMA’s grassroots campaign, BreakTheRedTape.org, provides a place for physicians to share their EHR stories with Congress and submit comments to CMS during the meaningful use Stage 3 comment period, which ends Dec. 15.

Email this page

Comments

What about PQRS? is that the greatest waste of time? should that be done away with?
We should be thinking beyond the next MU cycle. The term, Meaningful Use, is way more than what it sounds like – it is the CMS camel's nose in the tent: a massive intrusion into the practice of medicine, that has become a yoke some of us willingly put on, rather than a tool. I suggest that organized medicine should recognize the EHR for what it is – or perhaps more accurately what its potential is. <br/> <br/> We should think of the EHR as a (potentially) valuable tool that is integral to the practice of medicine, and develop its potential through using, say, VistA Extension and concentrate on stimulating innovation by means of a licensing regime that allows for wide distribution at nominal cost, and allows its end users to modify the code while sharing those modifications with others, along with a process of responsible governance. <br/> <br/> In this way – and I believe only in this way – can we develop the EHR into the valuable tool that it could be: a crowd-sourced tool to protect patient privacy and confidentiality of physician-patient communications, enhance patient safety from the ground up (not top-down), improve e-prescribing and decision-support, develop artificial intelligence, exploit big data, and so on. If we do that we will have achieved meaningful use in the plain meaning of the term. <br/> <br/> To accomplish the above, we will need the will and the commitment of organized medicine. In the meantime, while pursuing this kind of agenda, we need to be willing to make some financial sacrifice in the form of ignoring the MU demands placed upon us by HITECH.
Show Comments (2)
Oct 19, 2017
Congress urged to pass measure that would fund cost-sharing reduction payments, offer more health plan options and promote enrollment outreach.