AMA Demands Meaningful Use Program Changes

CHICAGO — The American Medical Association (AMA) has officially adopted a policy that calls on lawmakers to stop penalties within the federal government’s Meaningful Use program.

The Meaningful Use program is an electronic health record (EHR) incentive program initiated following the American Recovery and Reinvestment Act of 2009 that authorizes the Centers for Medicare and Medicaid Services (CMS) to award incentive payments to eligible professionals who demonstrate meaningful use of a certified EHR. The program has three stages, but incentives were only provided in Stage 1, which began in 2011. Stage 2 of Meaningful Use began this year and by 2015, eligible providers that have not adopted an EHR will face a financial penalty.

The AMA, headquartered in Chicago, is pressing for changes to the program after new analysis from CMS showed only 2 percent of physicians and less than 17 percent of hospitals have demonstrated Stage 2 Meaningful Use as of Sept. 30, the required reporting date for the 2014 fiscal year.

In response to the data, the AMA is urging policymakers to fix the program by adding more flexibility and shortening the reporting period to help physicians avoid penalties. Physicians representing the AMA also say that full interoperability is necessary to achieve the goals of EHRs — which are to facilitate coordination, increase efficiency and help improve the quality of care — but that is not widely available today.

"The AMA has been calling for policymakers to refocus the Meaningful Use program on interoperability for quite some time," said Dr. Steven J. Stack, AMA president-elect, in a statement. “The whole point of the Meaningful Use incentive program was to allow for the secure exchange of information across settings and providers and right now that type of sharing and coordination is not happening on a wide scale for reasons outside physicians’ control. Physicians want to improve the quality of care and usable, interoperable electronic health records are a pathway to achieving that goal.”

Although there are some systems on the market capable of interoperability, when data is transferred it is not always incorporated into the receiver’s EHR in a digestible way, making it difficult to act on and defeating the purpose of sharing, the AMA argues. Additionally, interoperability often comes at a price, which further hinders its use.

In addition to calling for EHRs to be more interoperable, physicians are also recommending that policymakers ease regulations to allow for EHRs to become more usable. To back its position, the AMA has been citing a 2013 report from AMA-RAND — a collaboration between the AMA and research firm RAND Corporation — that stated EHRs are a major source of dissatisfaction for physicians. The report found that physicians want to embrace technology, but they’re frustrated that regulatory requirements are forcing them to do clerical work and distracting them from paying close attention to their patients.

Physicians also raised concerns about interoperability in the study, saying that the inability of EHRs to "talk" to each other prevents the transmission of patient medical information when it is needed.

The AMA has provided the Office of the National Coordinator for Health IT (ONC) and CMS with a blueprint for improving the Meaningful Use program as well as a framework that outlines eight priorities for more usable EHRs.