EHRs in the era of MACRA

Barbara L. McAneny, MD , Former President

While it’s been a long—and sometimes rocky—road implementing electronic health records (EHRs), there’s no question that they’re here to stay. Their role is increasingly important under the Medicare Access and CHIP Reauthorization Act (MACRA), which is transforming the payment model and impacting the way we practice medicine.

This new era of Medicare payment is changing how we capture and report patient data, particularly as it relates to requirements under the new Quality Payment Program (QPP). Accounting for 25 percent of a practice’s Merit-based Incentive Payment System (MIPS) score, the Advancing Care Information (ACI) category replaces the former Medicare EHR Incentive Payment Program, commonly known as “Meaningful Use.”

Many EHRs allow for the storage and management of charts, remote access to patient data and e-prescribing, but many widely available EHR platforms do not offer the flexibility to exchange data with or interpret data from other systems. The medical community can contribute to the evolution of EHRs by partnering with vendors to improve EHRs, advocating for policymakers to develop effective health IT policy, and collaborating with physicians, institutions and health care systems to create effective institutional health IT policies.

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Time is ticking to participate in MACRA 2017

The AMA has worked with the Centers for Medicare & Medicaid Services (CMS) to ensure flexibility in the transition to MACRA and to ease the data requirements and administrative burden that can so easily detract from patient care. Under the 2017 Pick Your Pace approach, physicians may choose to report on a single quality measure this year and avoid a penalty. The AMA’s “one patient, one measure, no penalty” provides guidance and resources to help physicians successfully participate in MIPS.



That said, we should be planning for our future technology needs now. Engagement with data capture, sharing and reporting requirements earlier in our transition under MACRA will allow us the time to determine if, and how, our current EHRs meet the needs of our practices. As we plan, we should think about compliance and data management in the context of advancing practice efficiency.

The AMA MACRA page offers additional information on the ACI category of the QPP, as well as broad resources and advice for physicians seeking to successfully participate in 2017.

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