From modernizing how federal health data is shared to eliminating hassles for patients trying to confirm whether a physician is in their network, big changes are underway to help technology function better for physicians and their patients.
The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) have made changes to six key digital health polices—policies that come after the AMA’s relentless advocacy for them as a way to help ease physician and patient burdens.
For example, HHS’s new Health Technology Ecosystem will go a long way in modernizing health data by aiming to overhaul infrastructure to deliver complete, useable patient records at the point of care. The goal is to streamline health data exchange, reduce administrative burdens and enhance patient access.
Among the initiative’s high-impact tools and innovations:
- A National Provider Directory to better connect patients and physicians.
- Modernized digital identity systems for Medicare.gov users.
- Digital insurance cards to speed up claims and payment processing.
- A new trusted app library.
“This is a significant step toward fixing the broken health data system that frustrates physicians and fails patients,” said AMA President Bobby Mukkamala, MD. “This initiative responds directly to what physicians have been asking for— better data, less red tape and smarter use of technology. “It’s a meaningful shift that can help reduce physician burnout and help care teams focus more on patients and less on paperwork.”
The changes respond to AMA priorities outlined in a June comment letter (PDF) that urged HHS to build a more connected, transparent and patent-focused digital health system.
From AI implementation to digital health adoption and EHR usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors.
5 more digital technology wins
Other changes that came to fruition in recent months, after strong AMA advocacy on the issues.
Interoperability. New federal interoperability agreements require all participating EHRs to connect directly to CMS-approved national data-sharing networks. The systems must now deliver real-time, full patient information. This includes clinical notes, images and medication lists that physicians use in care, a change from the basic data fields that are now used.
The new HHS policies call for:
- Real-time data exchange.
- Automatic encounter notifications.
- Fewer login barriers for patients.
- Smart visit summaries.
This will make sharing patient data faster, easier and more complete, without physicians having to deal with extra logins, endless clicking or expensive add-ons.
“We’re finally moving past the days of chasing down records and critical patient details,” Dr. Mukkamala said. “Large institutions and small practices alike struggle with the lack of interoperability in patient records. Physicians will be able to quickly see what tests have been conducted and what treatments recommended.”
These changes can help prevent things such as duplicate lab orders when a patient had recent testing at another facility and can help catch medication changes made during a specialist visit. It will also allow for early intervention after an emergency department discharge because practices will receive a notification within 24 hours after one of their patients visits the emergency department or sees another clinician.
The AMA is pushing vendors to ensure the system works for small-practice environments and encourages physicians to start conversations with their vendors now to confirm timelines for 24-hour encounter alerts, support for updated connection capabilities and patient identity verification without new portal accounts.
Medicare Plan Finder. HHS is making upgrades to the Medicare Plan Finder so that patients can more easily find and choose plans that include their preferred physicians and hospitals, changes that mirror calls made in an AMA January advocacy letter (PDF) to the acting CMS director.
After hearing from patients struggling to navigate the Medicare Plan Finder, the AMA urged HHS to deliver a one-stop tool where patients can verify if a doctor or hospital is in-network; filter plans by specialty, location language and hospital affiliation; and avoid post-enrollment surprises.
The AMA, to ensure the upgraded Medicare Plan Finder is accurate and reliable, is urging HHS to require Medicare Advantage plans to, among other things:
- Submit provider network updates within 30 days of any changes.
- Provide a contracted provider list to HHS annually and whenever changes occur.
- Connect Medicare Plan Finder to a national, verified source of provider information to reduce errors and duplicates.
“Getting this right will reduce ‘are you in network?’ calls, curtail avoidable plan switches and spare front-desk staff the scavenger hunt across access portals,” Dr. Mukkamala said. “Bottom line: HHS heard physicians. When HHS makes this happen, patients will finally be able to pick a plan with confidence that their care team is in network.”
Real-time electronic prior authorization. New HHS policies call for a streamlined approach that embeds real-time electronic prior authorization into certified EHRs, ideas the AMA highlighted in a September 2024 comment letter (PDF). The policies will standardize how physicians and payers exchange information, paving the way for faster decisions and timelier patient care. Read more about the changes here.
Electronic prescribing standards. HHS adopted new electronic prescribing standards that enhance patient safety, reduce administrative burdens and streamline physician workflows. The policy incorporates updated prescribing directions, precise product identifiers and real-time access to current prescription data, closely following comprehensive recommendations the AMA made in a September 2024 comments letter. Read more about these changes.
Information-blocking prevention. HHS is increasing the resources it’s giving to inspectors to penalize health care entities that knowingly restrict patients from engaging in their care by blocking their access, exchange and use of electronic health information, commonly called information blocking. It’s an issue the AMA has long prioritized as a critical barrier to patient care and physician efficiency. Catch up with the news on these changes.
