On Dec. 15, the American Medical Association (AMA) released a set of recommendations to improve the troubled Meaningful Use program so it accommodates the real-world needs of physicians and patients while focusing on promoting the interoperability of electronic health records. The recommendations were included in comments the AMA submitted to the Centers for Medicare & Medicaid Services (CMS) on Stage 3 of the Meaningful Use program.
The AMA recommendations recognize that the landscape has changed since CMS originally issued regulations for Meaningful Use Stage 3. In April, Congress passed the Medicare Access and CHIP Reauthorization of 2015 (MACRA), which adopted a new physician payment framework based on quality and value. Transitioning to this new system requires that physicians have usable and interoperable tools that involve patients and support care coordination. Stage 3 must allow physicians to maximize the use of electronic health records in place today, while allowing vendors to continue to innovate and create new technologies.
“Doctors want to spend their time with patients, not measuring the number of clicks,” said AMA President Steven J. Stack, M.D. “We want a successful transition to digital health records, and we also want the new Medicare law to succeed. It will take thoughtful changes in the regulations to support physicians as they treat patients through new models of care.”
In the letter to CMS, AMA explains that this new framework is not a complete redesign. Rather, it aims to work within the current systems while offering “a glide path” to meet the new law. Program flexibility is the key factor in improving the Meaningful Use program, ensuring that Stage 3 objectives can align with advanced payment models. New payment systems will not work if physicians fail for missing just one of numerous requirements or are held accountable for technological failures outside of their control.
The AMA-proposed approach would also engage patients in their health care decisions rather than simply judging physicians on how well they transmit data.
The AMA has repeatedly called on CMS to address the challenges of the Meaningful Use program before moving on to Stage 3. Physicians have told their stories of trying to comply with the regulations as part of AMA’s Break the Red Tape campaign. The AMA partnered with RAND on a prominent study that found cumbersome EHR systems are taking a toll on physicians who feel increasingly demoralized by technology that interferes with their ability to provide first-rate medical care to their patients. Also, to leverage the power of EHRs for enhancing patient care, improving productivity, and reducing administrative costs, the AMA has outlined a framework of eight priorities for improving EHR usability. The AMA has also issued a blueprint for the future of the Meaningful Use program with recommendations to improve EHR functionality.