AMA: Changes are needed in the stage 2 meaningful use EHR proposal

A guest column by the American Medical Association, exclusive to

Continuing our efforts to move medicine forward while prioritizing patient care and minimizing administrative and financial burdens for physician practices, the American Medical Association (AMA) along with 100 state and specialty medical societies submitted a detailed comment letter to the Centers for Medicare & Medicaid Services (CMS). We urged CMS to make revisions so physicians can more easily participate in Stage 2 of the Medicare/Medicaid meaningful use electronic health record (EHR) program and allow them more time to incorporate EHRs into their practices to support practice efficiencies, improve quality of care delivery and enhance patient safety.

Changes to the meaningful use program are necessary to ensure that the program lives up to its intended purpose of helping physicians adopt, implement and meaningfully use EHRs. The AMA is very supportive of widespread adoption and meaningful use of EHRs, but the proposed criteria for Stage 2 will make it difficult for physicians to successfully participate.

Physicians’ number one focus must always be their patients. In addition to patient care, physicians are striving to adopt and implement new technologies into their practices while also dealing with the ongoing threat of steep Medicare physician payment cuts and reporting requirements for multiple federal programs including meaningful use, e-prescribing and the physician quality reporting system.

In March, the AMA and state and national medical societies sent a letter to CMS expressing serious concern about the onslaught of overlapping regulations that is creating extraordinary burdens for physicians. We urged CMS to re-evaluate penalty timelines and to develop solutions to synchronize these health IT and quality programs to minimize disruptions to physician practices and the patients we see.

Now, the AMA and 100 state and specialty medical societies are calling on CMS to make Stage 2 of the Medicare/Medicaid meaningful use EHR program more reasonable and achievable. These comments also include solutions for coordinating the overlapping health IT and quality programs to increase rates of physician participation.

To improve physician participation rates in the meaningful use program, CMS should fully evaluate Stage 1 to assess what is working and what can be improved prior to moving to Stage 2. Surveying both physicians who elected to participate in Stage 1 and those who didn’t would help identify barriers to physician participation. For example, if CMS’ evaluation of Stage 1 reveals that physicians did not participate in 2011 because they could not meet certain core measures, then adequate exclusions should be developed for these measures or these measures should be transferred to the Stage 2 menu set. This evaluation should be done prior to finalizing the Stage 2 requirements. Additional changes to the Stage 2 proposal are also needed and our outlined in our comment letter.

Advances in health IT have the potential to make physician practices more efficient while improving patient care. The AMA is committed to fostering these advances and will continue to work with CMS to develop solutions that will help physicians successfully participate in health IT and quality programs to move medicine forward forAmerica’s patients and physicians.

Peter W. Carmel is President, American Medical Association.

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