AMA Letter Details Blueprint for Stage 3 Meaningful Use Success

The American Medical Association (AMA) recently released a blueprint for the future of the meaningful use program with recommendations to improve EHR functionality for physicians and improve care for patients. The blueprint was included in a letter to the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) ahead of the proposed rule for stage 3 of the program.

“Physicians will always embrace technology that can help them provide better care for their patients and foster innovation, but improvements must be made to the meaningful use program in order for those goals to be achieved,” says AMA President Robert M. Wah, MD. “We can no longer just delay the program from taking full effect. We must make the necessary changes to ensure that the meaningful use program requirements are in fact meaningful and deliver—not hinder—the intended improvements in patient care and practice efficiencies.”

The recommendations included in AMA's meaningful use blueprint include the following:

• adopting a more flexible approach for meeting meaningful use to allow more physicians to successfully participate;
• better aligning quality measure requirements including reducing the reporting burden on physicians and helping relieve them from overlapping penalties;
• ensuring quality measures and clinical decision support within the program are current to improve care for patients and ensure physicians are following the latest evidence; and
• restructuring EHR certification to focus on key areas like interoperability.

The blueprint also highlights many different ways that CMS and ONC could improve the current and future meaningful use program, including simplifying the certification process to improve interoperability and usability, which the AMA recently highlighted in its usability framework. As part of its recommendations to improve the program, the AMA is asking the administration to make optional the objectives physicians are finding most challenging. These objectives include view, download, and transmit; transitions of care; and secure messaging. In addition, the AMA recommends that CMS and ONC take the opportunity with stage 3 to make the meaningful use program less primary care centric by expanding options within the HIT objectives to meet the needs of specialists and requiring physicians to meet no more than 10 requirements.

The letter also reiterates AMA concerns with stages 1 and 2 of the program, and offers recommendations for addressing the programs.

“The whole point of the EHR incentive program was to build an interoperable health information technology infrastructure that would allow for the routine exchange of important medical information across settings and providers and put medical decision-making tools in the hands of physicians and patients, yet that vision is not being realized and the lack of interoperability is stifling quality improvement,” says Wah. “While more than 78% of physicians are using an EHR, thousands have not participated in the meaningful use program or attested to stage 2, in large part because of the program’s all-or-nothing approach. Physicians should not be required to meet measures that are not improving patient care or use systems that are decreasing practice efficiencies. Levying penalties unnecessarily will hinder physicians’ ability to purchase and use new technologies and will hurt their ability to participate in innovative payment and delivery models that could improve the quality of care.”

The AMA has been advocating for more flexibility in all stages of the meaningful use program to encourage physicians to continue to integrate EHRs into their practices. That flexibility includes removing penalties for physicians who are making an effort to take part in meaningful use but are not meeting 100% of the program’s stringent requirements. The AMA recommends that physicians who meet at least 50% of the requirements in the current stages be able to avoid financial penalties and that stage 3 include just 10 required measures.

Source: American Medical Association