AMA: EHRs don't meet all Stage 1 meaningful use criteria

There is no EHR on the market today that does all of the steps required for physicians to successfully meet Stage 1 meaningful use criteria, according to an American Medical Association (AMA) statement released this week.

The AMA statement offered examples of the challenges ahead as a result of the Centers for Medicare & Medicaid Services' (CMS) released final rule on the Medicare and Medicaid EHR meaningful use incentive programs.

The association believes that it will be challenging for many physicians to participate successfully in the program. “This will be especially true for those physicians in solo or small group practices who have not previously utilized an EHR,” added the Chicago-based organization.

Although AMA acknowledged that the CMS did change certain regulations in the notice of proposed rulemaking on the final rule on the incentive programs, many challenges remain.

According to AMA, key barriers include:

• Timing: Physicians will only have a couple of months to purchase, implement and assess the usability of certified EHR technology prior to January 2011 (the start data of the program);
• Volume of measures: The volume of measures that physicians must meet totals 20, which is still too high;
• Hospital-based professionals: Hospital-based physicians are not eligible for incentives if they provide 90 percent or more of their services in an inpatient or emergency room setting;
• Timeframes for furnishing patient information electronically: The measures that require physicians to electronically produce, within several days, health information contained in EHRs conflict with HIPAA requirements that allow for a longer period of time for the production of medical records;
• Threshold requirements still too high: Some of the threshold requirements are still too high and some of the measures have narrow exclusions, which will be burdensome for physicians to meet;
• No appeals process: There is no mechanism for physicians to appeal any aspect of the incentive program;
• Usability: The certification process does not take into account whether a product will meet a physician’s unique workflow and practice needs, rather, it will only provide the means for meeting the meaningful use criteria;
• Early adopters: Physicians who are EHR early adopters must upgrade their systems to meet certification criteria in order to be eligible for incentives; and
• Testing of re-tooled measures: There is no guarantee that the e-specifications imbedded in EHR vendor products are accurate and operational.

AMA plans to host a webinar within the next several weeks to educate physicians on meaningful use program requirements.

The association is working with CMS, the Office of the National Coordinator for Health IT and other stakeholders on physician outreach and educational programs so that physicians have the information they need to begin the process of purchasing, implementing and meaningfully using their EHRs, the statement said.