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Physicians say regulations thwart meaningful use of EHR technology

HIM-HIPAA Insider, July 27, 2015

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by John Castelluccio

As helpful as technological advances offered by electronic health record (EHR) systems may be, physicians are saying the headaches due to government regulations on EHRs are outweighing the benefits.

Those were the sentiments expressed at a special July 20 town hall meeting convened by the American Medical Association (AMA) in Atlanta. The purpose was to allow physicians to air their concerns, frustrations, and successes with EHRs and CMS’ Meaningful Use incentive program.

“The message from physicians is loud and clear: electronic health record systems have so much potential, but frustrating government regulations have made them almost unusable,” said AMA President Steven Stack in a blog post, following the meeting. He was joined July 20 by U.S. Rep. Tom Price (R-Ga.), a former medical director at the orthopedic clinic at Grady Memorial Hospital in Atlanta. The input will be used to send a message to Congress on what’s working and what’s not, Stack said.

Numerous physicians who spoke at the meeting expressed frustrations at significant ongoing costs associated with EHRs, burdensome regulations, less time spent with patients, and decreased productivity and efficiency.

One physician, Melissa Rhodes, who works in pulmonary critical care and sleep medicine, confessed she was “fed up” and doesn’t expect to participate any longer in the Meaningful Use program. Her three-physician practice will just take the penalty instead.

Rhodes explained how she implemented her first EHR in 2006 well before legislation that established Meaningful Use. In the past year, her practice spent $84,000 on the EHR and related IT costs while the system won’t allow her to titrate orders for patients in the intensive care unit of the hospital with which she’s affiliated. She has to personally enter each order without assistance that could otherwise be available from the hospital nursing staff.

These types of limitations only hurt patient care and lead to more medical errors, she said, although she noted the e-prescribing function of the EHR was a great feature.

The big problem with EHRs, according to another physician who spoke, is they aren’t designed for patient care, but rather just to comply with federal regulations. He was concerned Meaningful Use is just pushing physicians further away from clinical decision-making and toward data mining.

More than 80% of physicians have by now implemented an EHR system, which was a goal of the meaningful use program, Stack noted. He said physicians are just being thwarted by the technology, however, with systems that won’t talk to each other, cost too much to maintain, and require inordinate amounts of time entering data instead of helping patients.

The AMA is trying to convince Congress to postpone roll out of the final stage of Meaningful Use until the existing problems are fixed. Stack said regulators’ plans to realign physician quality reporting programs under the new MACRA legislation still appear to avoid meaningful solutions to these issues.

And it seems lawmakers are listening. Senate Finance Committee Chairman Lamar Alexander (R-Tenn.) told reporters July 23 the committee plans to ask CMS to delay finalizing Stage 3 of Meaningful Use to allow time for the panel to submit recommendations for the incentive program. The recommendations were being drafted in a format that HHS could adopt through rulemaking instead of legislation, although if a bill were needed it would likely be tacked onto the 21st Century Cures Act, he said.

A video of the town hall meeting is available at live.breaktheredtape.org. You can also read more on this story on the HealthLeadersMedia website.

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