The American Medical Association and 98 state and specialty medical societies detailed recommendations for improvement in their comments on CMS' Stage 2 proposed rule for the Medicare and Medicaid electronic health record program.
While the AMA supports the widespread adoption and meaningful use of EHRs by physicians, the association believes the proposed criteria is cumbersome and will make successful participation difficult. For instance, the AMA contends that the extensive requirements for manual entry are an inefficient way to practice medicine and improve quality care outcomes for patients.
The AMA's comments propose the following recommendations to make Stage 2 more "reasonable and achievable:"
• Create more flexibility in meeting measures including exclusion and relevancy factors;
• Delete the high thresholds for new measures and for measures that cannot be met due to the lack of available, affordable and well-tested tools or exchange capabilities;
• Incorporate more focus on measures within a physician's control;
• Allow a significant good faith effort to meet measures in Stage 2 to count for incentives and for avoiding penalties;
• Eliminate back-dating the meaningful use penalty program and establish a number of exemption categories for hardship cases;
• Synchronize and improve the overlapping health IT and quality program requirements;
• Establish an appeals process under both the meaningful use and e-prescribing programs;
• Reduce the burden and add flexibility concerning clinical quality measure reporting and require testing of electronic specifications prior to use of CQM.
"Overall, the proposed Stage 2 requirements need to provide more flexibility to foster widespread EHR adoption," said AMA board chair-elect Steven Stack, MD. "Physicians are at varying stages of implementing health IT into their practices and should get credit for making a good faith effort to meet the meaningful use requirements."
AHA Expresses Concern Over CMS Proposed Stage 2 Meaningful Use Rule
While the AMA supports the widespread adoption and meaningful use of EHRs by physicians, the association believes the proposed criteria is cumbersome and will make successful participation difficult. For instance, the AMA contends that the extensive requirements for manual entry are an inefficient way to practice medicine and improve quality care outcomes for patients.
The AMA's comments propose the following recommendations to make Stage 2 more "reasonable and achievable:"
• Create more flexibility in meeting measures including exclusion and relevancy factors;
• Delete the high thresholds for new measures and for measures that cannot be met due to the lack of available, affordable and well-tested tools or exchange capabilities;
• Incorporate more focus on measures within a physician's control;
• Allow a significant good faith effort to meet measures in Stage 2 to count for incentives and for avoiding penalties;
• Eliminate back-dating the meaningful use penalty program and establish a number of exemption categories for hardship cases;
• Synchronize and improve the overlapping health IT and quality program requirements;
• Establish an appeals process under both the meaningful use and e-prescribing programs;
• Reduce the burden and add flexibility concerning clinical quality measure reporting and require testing of electronic specifications prior to use of CQM.
"Overall, the proposed Stage 2 requirements need to provide more flexibility to foster widespread EHR adoption," said AMA board chair-elect Steven Stack, MD. "Physicians are at varying stages of implementing health IT into their practices and should get credit for making a good faith effort to meet the meaningful use requirements."
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CHIME Suggests Changes to CMS Proposed Stage 2 Meaningful Use RuleAHA Expresses Concern Over CMS Proposed Stage 2 Meaningful Use Rule