Doctors Recommending Substantial Changes To Meaningful Use

By Megan Williams, contributing writer

The American Medical Association, in a letter to Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), has strongly recommended four changes to the Meaningful Use (MU) program.

The letter, addressed to Marilyn B. Tavenner, CMS administrator, and Karen B. DeSalvo MD, MPH, National Coordinator For Health Information Technology at the ONC, is nine pages long, and outlines not only the AMA’s recommendations, but also their high level view of the state of EHR (electronic health records) in the healthcare industry, physician adoption, criticisms of MU impact on patient safety, and goes on to explain the reasons for their recommendations.

Adopting A More Flexible Approach To MU

The association’s primary criticism of the program is its lack of flexibility and “all-or-nothing” approach. It suggests that implementing a 50-percent threshold for incurring a penalty, and an additional 75 percent threshold for qualifying for an incentive be implemented in stages 1 and 2. It also lists major challenges that physicians face, which included viewing, downloading and transmission, transitions of care, and secure messaging.

Interestingly to solutions providers, the letter also stressed the provision of new health IT measure to expand options for specialist participation around Stage 3 preparation, and suggested the retention of most of the measures of the Health Information Technology Policy Committee.

Expanding Hardship Exemptions For All Stages

The letter also emphasized the need for hardship exemptions at all stages of MU attestation. It specifically calls out:

• providing an exemption for Physician Quality Reporting System (PQRS) participants
• expanding the “unforeseen circumstances” hardship
• providing exemptions for hospitalists and physicians close to retirement

Improving Reporting

Reporting was addressed in the letter, with nods to multiple HIT areas including: improving alignment with the PQRS program, building quality reporting infrastructures, developing processes that “eliminate measures that no longer follow the latest clinical evidence,” and ensuring registry participation and interoperability.

Addressing Physician EHR Usability Challenges

The final recommendation of the letter covers physician usability of health IT. It suggests:

• incorporating well-developed data management principles
• adopting approaches that address user-centered design
• adopting the Health IT Certification/Adoption Workgroup recommendation that the certification program be revamped so that it focuses exclusively on interoperability, quality measure reporting, and privacy/security.

For more details, additional recommendations, and more insight into the AMA’s full take on the state of Meaningful Use, the original letter can be viewed here.