Concierge Medicine Today

AMA Calls For Overhaul Of Electronic Records Systems

By Erica Teichert

Law360, Washington (September 16, 2014, 5:47 PM ET) — The American Medical Association on Tuesday urged vendors and the federal government to revamp the electronic health record industry and create more usable products for physicians, saying the current regulations are too rigid and prevent physicians from realizing the benefits of the technology.

As it unveiled its new framework to overhaul the EHR industry, the association blasted the Obama administration for taking  an “all or nothing” approach to EHR adoption among Medicare providers and claimed the tactic has made it impossible for practitioners to acquire usable programs.

“We believe the meaningful use program and the regulatory structure associated with it initially has been a wonderful impetus to get healthcare to adopt the technology,” AMA president-elect Steven J. Stack said during a press call. “However, in its ongoing evolution, the meaningful use program … has become overly prescriptive, rigid, unreasonable and has become a barrier to the necessary evolution to allow these tools to be effectively deployed.”

Stack noted that an AMA study in partnership with Rand Corp. found that physicians lose an average of 48 minutes per day of patient time because of clunky EHR systems that turn doctors into “clerical staff” that fill information into the records rather than allow them to focus on patient needs.

The association has identified eight priorities to enhance EHR usability and benefits for patients ranging from supporting team-based care approaches to promoting data liquidity and reducing doctors’ cognitive workload.

Despite the hefty criticism of both EHR software and policy decisions, Stack said AMA fully supports EHR adoption and believe the technology will help reduce administrative costs and improve productivity if doctors can obtain more personalized tools.

“We think user-centered design features and approaches would go a long way if there was more flexibility in the meaningful use program to allow physicians to work directly with vendors to create tools that will help our work rather than check the box,” he said.

Ultimately, Stack said his top priority is pushing Congress and federal agencies to overhaul the EHR regulatory system, as those changes could trickle down and help vendors create better EHR solutions for doctors. He also criticized the administration for its looming penalties for hospitals and doctors who don’t make “meaningful use” of EHRs.

“We have stated in many domains, not just for EHRs that we don’t think this punishment approach to reforming health care is an effective policy lever,” he said.

AMA’s proposed framework was announced nearly a week after the U.S. Department of Health and Human Services abandoned plans to create a new set of optional certification standards for electronic health records, bowing to complaints from vendors and health care providers who had warned that the move would be destabilizing.

The HHS, which proposed the voluntary standards in February, explained its about-face in a final rule on Wednesday that acknowledged several concerns, including worries that EHR vendors would not have the time or money to meet the additional criteria.

The final rule instead adopted a “small subset” of the standards proposed in February and incorporated them into an existing set of criteria that EHRs must meet in order to be suitable for demonstrating so-called meaningful use and earning incentive payments from Medicare and Medicaid.

Specifically, 10 optional standards are being adopted, and two standards are being revised. The HHS, through its Office of the National Coordinator for Health Information Technology, or ONC, predicted Wednesday that “only a small number” of EHR vendors will try to meet those voluntary certification standards.

AMA said in April that it “does not believe that the ONC should create separate certification packages” because that sort of arrangement “will cause more confusion than it will solve.”

Since billions of dollars in incentive funds were authorized by the 2009 stimulus bill, EHRs have steadily expanded around the country. But that rollout has been accompanied by frequent complaints that EHR systems often are not user-friendly and that the federal government’s requirements for how they are used do little to improve patient care.

Last month, HHS supplied leeway by announcing that doctors and hospitals can use EHRs that comply with the “2011 Edition” of certification criteria, or a combination of the 2011 and 2014 editions, when demonstrating meaningful use this year.

–Additional reporting by Jeff Overley. Editing by Patricia K. Cole.


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