With the final rule for Stage 3 of electronic health record (EHR) meaningful use expected any day, physicians united Thursday in calling for policymakers to reevaluate the program and pause it until its prohibitive problems are fixed.
More than 40 national specialty societies joined the AMA in letters to Department of Health and Human Services Secretary Sylvia Burwell and Office of Management and Budget Director Shaun Donovan, warning that locking in Stage 3 rules for the meaningful use program would inhibit high-quality patient care and undermine implementation of Medicare payment reforms.
“If the administration finalizes the proposed meaningful use Stage 3 regulation now, vendors will create software that will lock in problematic technology, which physicians and patients will be living with for years to come,” the letters state.
The letters point out that the proposed Stage 3 regulation exacerbates the problematic policies of Stage 2, which requires physicians to meet “one-size-fits-all” criteria, rather than allowing them to focus on the clinical activities that would support patient care in their practices.
Implications of finalizing the rule
The Stage 3 proposed rule was developed before the Medicare Access and Chip Reauthorization Act (MACRA) was enacted earlier this year, the letters note. That means the rule also was written without consideration of the changes that law brings about. The meaningful use program will be a component of the new fee-for-service payment framework the MACRA introduces. High-functioning and interoperable EHRs also are expected to be essential resources for physicians who choose to participate in alternative payment models.
“There is growing bipartisan recognition in Congress that the direction of the meaningful use program needs to be reassessed in light of usability and interoperability challenges with EHR systems,” AMA President Steven J. Stack, MD, said in a news release. “Poorly performing systems that do not facilitate the seamless exchange of data would severely undermine the ability of the health system to support the implementation of the payment reforms outlined in MACRA.”
Through the AMA’s Break the Red Tape campaign, physicians have been sharing the repercussions meaningful use is having in their practices. As one physician observed, “I must make [a choice] between direct care for sick, needy, dying and suffering patients, and the need to satisfy the many EHR requirements to complete the visit …. The health of patients is taking a back seat to the need to chart ostensibly to satisfy administrative, regulatory and financial needs.”
Not surprisingly, while 80 percent of physicians have adopted EHRs in their practices, less than 10 percent of physicians have successfully participated in meaningful use Stage 2 so far.
Calls in Congress
Several members of Congress are calling for a delay of meaningful use Stage 3. That includes a bill introduced in July by Rep. Renee Ellmers, R-N.C.
Just this week, Senate Health Committee Chairman Lamar Alexander, R-Tenn., called for a delay in making Stage 3 rules final until 2017.
“Patients need an interoperable system that enables doctors and hospitals to share their EHRs,” Sen. Alexander said at a Senate hearing. “But the government, doctors and hospitals need time to do it right.”
What you can do
Federal policymakers need to hear from you. Join the groundswell of physician input by sharing your experiences and stories of how EHRs and current meaningful use regulations have impacted your practice and the care you provide your patients. Visit breaktheredtape.org, where you also can see testimonies from your fellow physicians.
While there, you can quickly send an email to your members of Congress, asking them to halt Stage 3 of meaningful use until the program is fixed.
Also plan to participate in a special town hall meeting from 6:30 to 8:30 p.m. Eastern time Sept. 29 at the Massachusetts Medical Society’s headquarters in Waltham, Mass. The meeting will give participants an opportunity to shine a spotlight on the problems with meaningful use regulations and what they have meant for your patients and practice.
