Usability issues with electronic health records (EHR) and unrealistic requirements for the meaningful use program rank among the chief causes of professional dissatisfaction among physicians, but more than four out of five doctors say they prefer to stick with this evolving technology that holds the promise of enhancing care than return to paper records, according to an AMA study by the RAND Corporation.
Here’s how the AMA is getting EHR systems and program requirements on the right track:
Improving technology
Through its Professional Satisfaction and Practice Sustainability initiative, the AMA is developing a set of characteristics and recommendations to improve the usability of EHR systems, identifying opportunities to achieve these improvements, and determining a research agenda to advance the evidence base for increasing usability.
Among the top challenges identified so far are reduced productivity as a result of poor design and restrictive regulations, interference with face-to-face patient care, and a lack of interoperability. The AMA is taking these concerns directly to EHR vendors to encourage them to make the necessary changes in their future product designs and is working with the Electronic Health Records Association on these efforts.
In a recent letter to National Coordinator for Health Information Technology Karen B. DeSalvo, MD, the AMA called for an overhaul of the certification process for EHR technology to refocus attention on a more narrow set of requirements, such as achieving interoperability and usability. The AMA has been heavily engaged with Dr. DeSalvo, who assumed her post in January.
Revamping the meaningful use program
The AMA continues its intensive advocacy to address overly burdensome EHR regulations. Important improvements to the meaningful use program that the AMA has achieved for physicians include:
- Influencing the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) to release a proposed rule that would extend the timeframe of Stage 1 through 2014 and allowing physicians to use their currently installed Version 2011 certified EHR software
- Extending Stage 2 through 2016
- Securing additional hardship exemptions to help physicians avoid financial penalties
- Convincing the influential health care information technology policy committee to reevaluate the currently broken EHR certification process
Under the leadership of Dr. DeSalvo, the ONC also has streamlined its health IT workgroups. The AMA expects that these more narrowly focused groups will include more practicing physicians to better address their needs and concerns.
Dr. DeSalvo personally requested input from the AMA prior to rulemaking for meaningful use Stage 3, which the AMA submitted last month in a formal letter. Among other recommendations, the letter reiterated the need for scrapping the all-or-nothing approach to meeting the program’s requirements and replacing it with a 75 percent pass rate for an incentive and 50 percent pass rate for avoiding a penalty.
The AMA also has surveyed medical specialty societies about their priorities for Stage 3 and plans to send CMS a more in-depth letter reflecting these findings.
The AMA continues to press strongly for a more flexible set of criteria physicians must meet to achieve meaningful use and avoid financial penalties.
Developing physician tools
Finally, the AMA is working to develop and distribute educational modules that will equip physicians to be better purchasers, implementers and users of EHR technology. The AMA plans to release these materials later this year.
