5 things to know from AMA’s interim meeting

The American Medical Association’s interim meeting included the adoption of policies on a variety of topics, including team-based care, interoperability, value-based drug pricing and expanding research on head injuries. Here are some highlights from the policy discussions:

1. Guidelines for team-based care

The AMA delegates adopted a set of ethical standards for physicians acting as leaders or members of a collaborative care team. AMA board member Kevin Williams said the team-based approach has proven to be effective in providing high quality care.

“An effective team requires vision and direction of an effective leader and physicians are uniquely suited to serve as a clinical leader who will ensure that the team as a whole functions effectively and facilitates patient-centered decision-making,” Williams said.

The guidelines should physicians leading care teams should first understand each team member’s expertise and skills, as well as their contributions to patient care. Other steps include articulating each member’s responsibilities, encouraging and adopting suggestions from other members and openly discuss ethical and clinical concerns.

2. EHR changes

Among the policies adopted by the AMA delegates were two related to electronic health records (EHRs). First, it “strengthened” its stance on EHR interoperability by coming against data blocking for unaffiliated physicians.

“Just because physicians are not affiliated with a hospital does not mean that they should not have access to patients’ records,” AMA board member Russell W. Kridel. “Timely, safe and optimal care depends on physicians’ ability to access electronic health records. A cornerstone of interoperability is that data is accessible to physicians, regardless of their connection to a hospital or health organization.”

The association also supported voluntarily including information like a patient’s gender identity, sexual orientation and preferred pronoun(s) in their EHR.

3. Addressing opioid abuse

New policies adopted at the meeting called for residencies and fellowships providing clinical experience on treating opioid abuse to be expanded.

“The AMA supports efforts to confront the opioid and prescription drug epidemic so physicians who are on the front lines have the ability to best meet patient needs,” said AMA board member Jesse M. Ehrenfeld, MD.

Additionally, the AMA adopted a policy to prevent drug companies from misusing Food and Drug Administration protocols for dangerous prescriptions, such as opioids, to block generics from entering the market. The AMA policy would support the “mandatory provision of samples of approved out-of-patent drugs upon request to generic manufacturers.”

4. More research into CTE

The delegates voted to encourage more research on detection, causes and consequences of head injuries, including chronic traumatic encephalopathy (CTE). CTE is a progressive degenerative condition of the brain often found in athletes with a history of multiple concussions, though sports leagues like the NFL denied any connection for years.

Currently, CTE is “very difficult” to diagnose before death.

“With hundreds of thousands of Americans—including approximately 250,000 children under age 19—sustaining concussions each year, it is vital that we research the full continuum of head impacts,” said AMA board Willarda V. Edwards, MD. “Whether the concussion occurs during youth sports like football, soccer, and basketball or during a military deployment, the insidious symptoms of CTE are occurring eight or 10 years after the inciting event. Further research into the causes, prevention, and detection of CTE are critical, but we must begin this effort by understanding how to prevent it.”

5. Supporting drug pricing changes

The AMA’s new policy called value-based drug pricing a “viable cost-saving solution” for changing how prices for patients are determined. The continuing rise in pharmaceutical prices—98.6 percent since 2011, according to the AMA—is a big driver in the healthcare spending growth and one of the top priorities for healthcare consumers.

“The new AMA policy acknowledges the carte blanche approach to drug pricing needs to change to align with the health system’s drive for high-quality care based on value,” said AMA President Andrew  Gurman, MD. “This transformation should support drug prices based on overall benefit to patients compared to alternatives for treating the same condition. We need to have the full picture to assess a drug’s true value to patients and the health care system.”

AMA’s policy said it will support value-based drug pricing initiatives which base prices on clinical evidence, have prices set by “objective, independent entities,” follow a transparent process and allow for patient variation and physician discretion.