Frustrated AMA Pitches ‘Action Plan’ On Digital Records

Saying that electronic health records distract doctors, take time away from care and make physicians less productive, an influential doctors鈥 group 聽to develop better, easier-to-use technology.

The American Medical Association聽asked the Obama administration to abandon its 鈥渁ll or nothing approach鈥 requiring Medicare providers to go digital or be penalized. The group also wants the government聽 to develop better certification criteria for vendors selling electronic record systems.

It聽outlined eight areas for overhauling聽the record systems, with the top priority being to make sure the technology enhances, rather than disrupts patient care. Electronic health records should also promote coordination, enable physicians to delegate to other health care providers and be able to interact with patients鈥 mobile devices.

Under the 2009 economic stimulus package, to switch from paper to electronic records with the goal of reducing costly errors and duplication and boosting coordination.聽聽The law offers doctors who treat Medicare patients up to $63,750 over five years to help pay for the change if they can prove they鈥檙e making 鈥渕eaningful use鈥 of the systems by, say, submitting prescriptions electronically. 聽Those who do not go digital are supposed to have a percentage of their Medicare payments withheld beginning next year.聽 However, the government recently agreed to give聽certain providers聽more time and flexibility.

The AMA says that isn’t sufficient to address the problems.

鈥淭he meaningful use program and the regulatory structure associated with it initially has been a wonderful impetus to get health systems to adopt [electronic health records],鈥 said Dr. Steven J. Stack, president-elect of the AMA, adding: But聽the “processes associated with it have become overly prescriptive, rigid and unreasonable and have themselves become a barrier.鈥

The group said that one of physicians鈥 chief concerns is that the programs often have clunky menus that require what it called 鈥渢he collection of time-consuming information of questionable value鈥 and data that is no more than 鈥渃lutter,鈥 such as lists that do not differentiate between a patient’s current and out-of-date聽medications.

That聽information distracts the physician, is often irrelevant to the care of the patient and leads to 鈥渆xcessive clicking and scrolling鈥 on behalf of the doctor, the organization said.

鈥淲e do not want to go back to paper records, but today鈥檚 current E.H.R. products are immature, costly and not well designed to improve clinical care,鈥 Stack said. 鈥淩equiring electronic health records to be all things to all people — regulators, payers, auditors and lawyers — diminishes the ability of the technology to perform the most critical function, helping physicians care for their patients.鈥

Asked whether they’re seeking delays to the programs penalties beginning next year, Stack said that’s not the group’s goal.

“We would not shy away from accepting delays but have not made that our focus,” he said.

In addition to聽the criticisms laid out Tuesday,聽the AMA had joined with the American Hospital Association and 15 other groups to ask the administration聽to let providers show meaningful use of electronic health records for three months in 2015, as opposed to a full year — arguing the program’s success hinges on the agency offering flexibility.

A spokesman for the Obama administration encouraged doctors to communicate what they need to vendors and others.

鈥淲e support the AMA鈥檚 efforts to improve EHRs for the end user 鈥 the health care providers who use these products to treat their patients,鈥 said Peter Ashkenaz, spokesman for the Office of the National Coordinator for Health Information Technology at the Department of Health & Human Services.

But, he added, 鈥淲e also know that no software is perfect, and therefore no EHR is perfect.鈥

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