Distressed docs turn up heat on ONC

Meaningful use, EHR certification, interoperability targeted
By Bernie Monegain
09:38 AM
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A coalition of 35 physician organizations led by the American Medical Association says docs are fed up their electronic health records and the multitude of requirements that come from the federal meaningful use program. They have a seven-point plan for relief.

"Among physicians there are documented challenges and growing frustration with the way EHRs are performing," the coalition writes in its Jan. 21 letter to National Coordinator Karen DeSalvo, MD. "Many physicians find these systems cumbersome, do not meet their workflow needs, decrease efficiency, and have  limited, if any, interoperability."

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Moreover, they add, ONC-certified EHRs raise safety concerns: "We believe there is an urgent need to change the current certification program to better align to testing to focus on EHR usability, operability snd safety."

The medical societies urge ONC to adopt their seven-point plan for improving EHR certification.

  1. Decouple EHR certification from the meaningful use program.
  2. Reconsider alternative software testing methods.
  3. Establish greater transparency and uniformity on user-centered design testing and process results.
  4. Incorporate exception handling into EHR certification.
  5. Develop CCDA guidance and teststo support exchange.
  6. Seek further stakeholder feedback.
  7. Increase education on EHR implementation.

The coalition elaborated on its concerns for patient safety.

"Unfortunately, we believe the meaningful use certification requirements are contributing to EHR system problems and we are worried about the downstream effects on patient safety," the physicians wrote, adding that medical informaticists and vendors had told members of the coalition that meaningful use certification had become a priority in health IT design at the expense of physician and patient needs.

The coalition members said they'd also become concerned over the lack of ONC oversight regarding EHR certification.

The physician groups also raised concerns about information security and lagging interoperability. They especially emphasized the need to separate the meaningful use program from EHR certification.

"We are concerned  that if the administration were to maintain the program, as currently structured, EHR innovation will languish and improvements in performance, quality, safety, interoperability and efficiency will continue to be out of reach."

In a Jan. 15 letter responding to ONC's call for comment on its federal strategic plan, the American Academy of Family Physicians, part of the coalition, also took ONC to task.

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"We are concerned that work has not been done to determine why these goals have not been achieved during the past 10 or more years and how the tactics and activities of the next 10 years will be different," AAFP Board Chair Reid Blackwelder, MD, wrote in the response, referring to interoperability.

Access the 35-member coalition's full letter here.