by Dara J. Barrera, MSMS Manager of Practice Management and Health Information Technology, and Stacey P. Hettiger, MSMS Director of Medical and Regulatory Policy
It feels like the federal government is rushing physicians to adopt EHRs that don’t provide physicians with the support they need to provide quality physician-patient care. Instead, compliance with government-imposed “Meaningful Use” objectives creates a costly burden and impractical expectations. It prevents physicians from providing the highest level of care for their patients. What recourse do physicians have to express their concerns?
The federal government’s Meaningful Use (MU) program requires that physicians adopt electronic health records (EHRs) or receive lowered Medicare payments. However, physicians want assurances that they are investing in the right EHR systems that will help them improve patient care in an efficient and thoughtful manner. Although initial MU incentives have helped to spur adoption, more than 80 percent of physicians have EHRs in their practices, only 12 percent of physicians have been able to successfully participate in Stage 2 of MU. This statistic highlights the need to adopt policies that help physicians embrace new technology while eliminating regulations that hold back progress. Over the past several years, physicians have been bringing to the forefront problems with the program and asking for remedies that would support physicians in providing the best care possible for patients. These remedies need to include the development of innovative EHR technologies that meet the needs of physicians and their practices and that advance the sharing of patient data among the professionals who are providing their care.
“Break the Red Tape” Campaign
In response to the physician outcry against the Meaningful Use requirements, the American Medical Association (AMA) launched it’s “Break the Red Tape” campaign. It includes a website (BreaktheRedTape.org), and other initiatives designed to help inform and include physicians in the discussion about making changes to the program. As part of that effort, the AMA is encouraging physicians to visit BreaktheRedTape.org to tell Congress and relevant agencies how rushing MU Stage 3 creates a costly burden and limits innovation. The premise is that forcing physicians to adopt costly and complicated EHRs on an unrealistic timeline entangles both patients and physicians in problematic red tape.
The outcry against EHR adoption and use has lead to myth that physicians don’t want to use technology. This is actually false. Surveys show that physicians and care teams actually embrace new technology that helps to prevent disease, and diagnose and treat patients. Most physicians use tablets, personal and desktop computers and smart phones to streamline their day-to-day work. However, current versions of EHRs and the MU regulations can make their daily jobs more complicated and can lead to issues that decrease satisfaction for both the physician and the patient, such as increased wait time for patients, decreased time spent with patient/physician, and inconsistency in information. AMA President Steven Stack, MD, stated, “We want to promote interoperability of EHRs, improve usability and increase patient engagement.”
ONC Complaint Online Form
The Office of the National Coordinator (ONC) has developed an online complaint form to assist physicians with issues related to their EHR. The complaint tool is designed to ensure your issue or concern gets to the appropriate person at the ONC or other department within the federal government. As challenges and changes arise, physicians are encouraged to contact their vendor as a first step towards resolving any issues. If your issue is related to the products certified capabilities, then you should contact the ONC – Authorized Certification Bodies, who should be able to work with you to find a resolution. If the issue remains unresolved, submit your complaint to the ONC via the online complaint form. Keep in mind that logging your complaint may not resolve your complaint, but will allow for further conversation between you, your vendor, and the ONC to address the issue and make changes. It is the goal of the ONC to provide a more centralized and streamlined customer service process that will not only aid the physician’s complaint reporting process, but help find ways to address information blocking and improve security, safety and usability of EHRs. For more information or to view the complaint form, visit HealthIT.gov/healthitcomplaints.
MSMS and organized medicine ongoing activity
MSMS, along with the AMA and over 100 other medical societies, recently sent a joint letter to Congressional leaders asking Congress to take immediate action to refocus the Meaningful Use (MU) program on the goal of achieving a truly interoperable system of electronic health records. The letter stressed that the MU program has grown into a “morass of regulation,” “failed to focus on interoperability,” and “created new barriers” to data exchange across care settings. Below are some excerpts from the letter highlighting the importance of program redesign, realistic and appropriate expectations, and evolving technology that truly provides the information sharing and tools necessary to improve patient care.
“Congressional action to refocus this program is urgently needed before physicians, frustrated by the near impossibility of compliance with meaningless and ill-informed bureaucratic requirements, abandon the program completely.”
“…as the regulatory scheme to measure “meaningful use” of this technology has evolved, the Centers for Medicare & Medicaid Services (CMS) has continued to layer requirement on top of requirement, usually without any real understanding of the way health care is delivered at the exam room level.”
“We believe that the success of the program hinges on a laser-like focus on promoting interoperability and allowing innovation to flourish as vendors respond to the demands of physicians and hospitals rather than the current system where vendors must meet the ill-informed check-the-box requirements of the current program.”
Also, it is important to remember that MSMS and AMA policies concerning the MU program and EHRs are driven by active delegates to each organizations respective House of Delegates (HODs). The HOD is the official legislative and policy-making body of MSMS and the AMA. During these meetings, resolutions are one of the vehicles used to debate and determine the policies, priorities, and direction of MSMS and the AMA during the ensuing 12 months and beyond.
For example, at the 2015 MSMS HOD meeting, a resolution was adopted supporting efforts to advocate the Centers for Medicare & Medicaid Services suspend penalties to physicians and health care facilities for failure to meet Meaningful Use criteria. Recently, at the 2015 AMA Interim HOD meeting, new policy was adopted supporting efforts to accelerate the development and adoption of universal and enforceable EHR interoperability standards for all vendors before the implementation of Medicare’s Merit- Based Incentive Payment System (MIPs).
Steps you can take.
Engage with MSMS
- Email your members of Congress via http://msms.org/engage. Via the website, it takes less than a minute to let them know that the nation’s patients and physicians need significant changes to Stage 3 of meaningful use.
- Keep up on current topics and events by receiving and reading Friday’s Medigram email blast.
- Participate in MSMS’s House of Delegates (HOD) meeting as a delegate or as a resolution author. The MSMS HOD meets annually in the spring. The best way to get your idea or recommendation adopted as a Society policy or directive is at the grassroots level. To do so, present your suggestion and rationale at your county medical society meeting. If the county agrees, the county will work with you to draft a resolution to be presented at the next HOD meeting. The resolution should specify the desired Society policy or directive for Society action. If the county does not agree with your idea, you can ask another delegate to submit a resolution on your behalf as an individual delegate. It is also prudent to check the Society’s current Policy Manual and, if relevant, the AMA Policy Finder to determine if policy on the issue already exists.
Check-out the AMA’s “Break the Red Tape” website Through this website, you can:
- Email your members of Congress. Via the website, it takes less than a minute to let them know that the nation’s patients and physicians need significant changes to Stage 3 of meaningful use.
- Share your story. Join your peers in telling your story about how meaningful use regulations are affecting your patient-physician relationships.
File a Complaint.
- Use the ONC Online Complaint Form at HealthIT.gov/healthitcomplaints.