The American Medical Association (AMA) lobbied the Centers of Medicare and Medicaid Services (CMS) to implement its version of a revamped meaningful use program in a 30-page letter. The AMA, which has been a long thorn in CMS’ side regarding EHR adoption, meaningful use and ICD-10 implementation, outlined its vision for the meaningful use program urging for a full assessment to improve the program before moving on to stage 3.
The AMA’s recommended changes include adopting a more flexible approach for meeting meaningful use to make it easier for providers to avoid reimbursement penalties, expanding hardship exemptions for all stages, improving quality reporting and addressing physician EHR usability challenges.
In terms of adopting a more flexible approach for meeting meaningful use measures, the AMA suggested that rather than expanding the reporting requirement, the list of measures should be refined and focused on the primary goals of the program. Another recommendation made was to expand hardship criteria to relieve physicians who struggle to meet reporting mandates from paying penalty fees. Recommended additions to hardship categories include providing an exemption to hospitals, physicians who successfully participated in the PQRS program and physicians who are close to retirement.
The AMA also included possible changes to present quality reporting timelines by choosing not to expand reporting measures until IT infrastructure challenges are resolved, more flexibility is instituted and existing quality measures are updated to comply with changes in practice guidelines.
In the letter, the AMA explains that despite the increase in EHR adoption, there has been a growing level of physician dissatisfaction with EHRs and the meaningful use program. Some of the issues listed include poor usability, time consuming data, interference with face-to-face patient care and regulatory requirements. The growing dissatisfaction affecting physicians’ workflow as they spend much time on documentation and administrative duties related to EHR. To best address usability issues, the AMA recommended that in addition to physicians, licensed professionals and medical assistants should be able to enter orders for patients, too.