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AMA, Medical Societies Ask Congress to Alter Meaningful Use

AMA and 111 medical societies has written Congress to address shortcomings in the Stage 3 Meaningful Use final rule.

By Kyle Murphy, PhD

The American Medical Association (AMA) is leading a campaign to compel Congress to intervene in the timeline for Stage 3 Meaningful Use. Along with 111 medical societies, AMA has written majority and minority leaders of the Senate and House of Representatives to "refocus" the final stage of the EHR Incentive Programs.

"While the overall goal established by Congress in the HITECH Act, namely to promote widespread adoption of electronic health records by physicians and hospitals, has largely been achieved, the Stage 3 requirements are inconsistent with the goal of promoting better coordinated and high quality patient care," the letters state.

The AMA-led coalition points to the "widespread failure" of Stage 2 as proof that the architects of the EHR Incentive Programs and their meaningful use requirements have missed the mark despite repeated calls to alter them.

CMS recently released modifications to Stage 2 to make modest improvements, though some new requirements will cause still more physicians to fail. Simultaneously CMS laid out more challenging requirements for Stage 3. Rather than build on the modest improvements made to Stage 2, CMS reverted back to the same fundamental flaws in the previous version of the program by focusing heavily on measure thresholds and excessive documentation requirements rather than improving interoperability. Relying so heavily on the failed construct of Stage 2 will only guarantee continued failure in Stage 3.

A major gripe of the AMA and other medical societies is the limited focus on advancing interoperability they perceive to be a flaw of Stage 2 and Stage 3:

"We believe that the success of the program," the letters continue, "hinges on a laser-like focus on promoting interoperability and allowing innovation to flourish as vendors respond to the demands of physicians and hospitals rather than the current system where vendors must meet the ill-informed check-the-box requirements of the current program."

Another is the alleged unwillingness of the Department of Health & Human Services and Centers for Medicare & Medicaid to respond to stakeholder feedback in a meaningful way.

"The Administration has not responded to this need and instead has chosen to perpetuate the current failed program through the release of Stage 3 Meaningful Use. It is unrealistic to expect that doing the same thing over and over again will result in a different outcome," the letters read.

All of this criticisms have compelled the AMA-led coalition to write Congressional leaders to take matters into their hands and force HHS/CMS to make key changes to meaningful use requirements.

"We believe, therefore, that it is time for Congress to act to refocus the Meaningful Use program on the goal of achieving a truly interoperable system of electronic health records that will support, rather than hinder, the delivery of high quality care," the letters conclude.

CMS posted the final rule for meaningful use modifications between 2015 and 2017 and Stage 3 in the middle of October. The most significant of the modifications were the reduction in the duration of the 2015 reporting period, from 365 days to 90 days for providers in the first year of Stage 2, and reducing the patient engagement threshold from 5 percent to a single patient.

What surprised many eligible providers, however, was the coupling of these meaningful use modifications with the final rule for Stage 3. The final stage of the EHR Incentive Programs is volunteer for eligible providers to opt in to in 2017 and required for all eligible professionals and hospital in the Medicare program beginning in 2018.

The Stage 3 final rule came with a 60-day reporting period. In response to the publishing of these rules, AMA called on CMS to use this two-month window to consider serious changes to Stage 3.

"We urge CMS to use the additional public comment period provided for Stage 3 to further improve the program and consider changes related to the Medicare Access and CHIP Reauthorization Act, which was signed into law earlier this year," AMA President Steven J. Stack, MD, said last month. "We also want to make sure that EHR vendors have the time they need to further test products for interoperability, usability, safety and security. We hope that health IT certification is nimble enough to accommodate future technology innovations and that the program not seen as final at this time."

AMA and others apparently do not have complete trust in HHS and CMS to do so.




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