Medical practice, informatics groups weigh in on Stage 2
A pair of organizations representing medical groups and informaticists have issued formal comments to the Office of the National Coordinator for Health IT (ONC) regarding the proposed Stage 2 objectives for meaningful use.
The ONC's Health IT Policy Committee (HITPC) should reappraise the timetables and requirements for Stage 2 meaningful use, wrote the American Medical Group Association (AMGA) in its comments on the preliminary proposals for Stage 2. The HITPC should also consult with providers and vendors to evaluate whether vendors can provide the necessary electronic infrastructure to eligible professionals in the prescribed periods, according to the trade association, which represents multispecialty medical groups and other organized systems of care.
AMGA members are hearing from their software vendors that they will not be able to meet the Stage 2 timeframes, the Alexandria, Va.-based organization’s letter stated.
AMGA emphasized the need for further detail on several of the proposed objectives, the need to scale back some of the more aggressive requirements and the importance of using definitions that are consistent with those commonly used in healthcare delivery. For example, AMGA asked for additional clarification for the “Employ drug-drug interaction checking and drug-allergy checking on appropriate evidence-based interactions” objective. “The term ‘appropriate evidence-based interactions’ should be defined more precisely in the forthcoming Stage 2 proposed rule,” the letter read.
AMGA also suggested that instead of the term “smoke status” in the “Record smoking status” objective that “tobacco use” should be used because “it is consistent with commonly used clinical terminology.”
The group also called on the HITPC to describe the intent of the “Implement one computerized decision support rule.”
“We urge the HITPC to make recommendations to the Centers for Medicare & Medicaid Services that will reflect the incremental nature of EHR adoption within organizations and the need to ensure that the increased requirements for Stage 2 are attainable for healthcare providers.”
AMIA: Cognitive support concerns
Separately, the American Medical Informatics Association (AMIA) stated that criteria and measures for meaningful use seem to be “somewhat arbitrary ‘add-on’ functionality” that may or may not support valid use of EHRs by clinicians in their practices.
In its Feb. 25 letter to the ONC, AMIA also expressed concern that the current EHR certification process doesn’t include adequate cognitive support to ensure the technology is used in a meaningful way.
AMIA, a Bethesda, Md.-based organization of 4,000 biomedical and health informatics professionals, applauded the rapid pace at which the HITPC and HIT Standards committees have worked to advise the Department of Health and Human Services (HHS) as it implements the incentive program. However, the organization also said it is concerned about the wide range of goals at which Stage 1 and now proposed Stage 2 objectives seem to be aimed, from stakeholder behavior to “shaping and, in some instances, dictating” health IT functions and performance.
Another AMIA concern is that EHR incentives may create significant burdens for providers and are only indirectly related to advancing processes of care or improvements in quality, safety or efficiency.
AMIA recommended that only mature technology applications that have demonstrated efficacy should be included as meaningful use criteria in Stage 2 and Stage 3. “We encourage the HITPC to continue to consider MU objectives that reflect the inter-disciplinary nature of care delivery and care coordination beyond the walls of the hospital and beyond the current spectrum of eligible providers,” the letter stated.
The full text of the AMGA letter can be accessed by clicking here. Click here to see AMIA’s complete comments.
The ONC's Health IT Policy Committee (HITPC) should reappraise the timetables and requirements for Stage 2 meaningful use, wrote the American Medical Group Association (AMGA) in its comments on the preliminary proposals for Stage 2. The HITPC should also consult with providers and vendors to evaluate whether vendors can provide the necessary electronic infrastructure to eligible professionals in the prescribed periods, according to the trade association, which represents multispecialty medical groups and other organized systems of care.
AMGA members are hearing from their software vendors that they will not be able to meet the Stage 2 timeframes, the Alexandria, Va.-based organization’s letter stated.
AMGA emphasized the need for further detail on several of the proposed objectives, the need to scale back some of the more aggressive requirements and the importance of using definitions that are consistent with those commonly used in healthcare delivery. For example, AMGA asked for additional clarification for the “Employ drug-drug interaction checking and drug-allergy checking on appropriate evidence-based interactions” objective. “The term ‘appropriate evidence-based interactions’ should be defined more precisely in the forthcoming Stage 2 proposed rule,” the letter read.
AMGA also suggested that instead of the term “smoke status” in the “Record smoking status” objective that “tobacco use” should be used because “it is consistent with commonly used clinical terminology.”
The group also called on the HITPC to describe the intent of the “Implement one computerized decision support rule.”
“We urge the HITPC to make recommendations to the Centers for Medicare & Medicaid Services that will reflect the incremental nature of EHR adoption within organizations and the need to ensure that the increased requirements for Stage 2 are attainable for healthcare providers.”
AMIA: Cognitive support concerns
Separately, the American Medical Informatics Association (AMIA) stated that criteria and measures for meaningful use seem to be “somewhat arbitrary ‘add-on’ functionality” that may or may not support valid use of EHRs by clinicians in their practices.
In its Feb. 25 letter to the ONC, AMIA also expressed concern that the current EHR certification process doesn’t include adequate cognitive support to ensure the technology is used in a meaningful way.
AMIA, a Bethesda, Md.-based organization of 4,000 biomedical and health informatics professionals, applauded the rapid pace at which the HITPC and HIT Standards committees have worked to advise the Department of Health and Human Services (HHS) as it implements the incentive program. However, the organization also said it is concerned about the wide range of goals at which Stage 1 and now proposed Stage 2 objectives seem to be aimed, from stakeholder behavior to “shaping and, in some instances, dictating” health IT functions and performance.
Another AMIA concern is that EHR incentives may create significant burdens for providers and are only indirectly related to advancing processes of care or improvements in quality, safety or efficiency.
AMIA recommended that only mature technology applications that have demonstrated efficacy should be included as meaningful use criteria in Stage 2 and Stage 3. “We encourage the HITPC to continue to consider MU objectives that reflect the inter-disciplinary nature of care delivery and care coordination beyond the walls of the hospital and beyond the current spectrum of eligible providers,” the letter stated.
The full text of the AMGA letter can be accessed by clicking here. Click here to see AMIA’s complete comments.