The AAFP knows all too well that family physicians are frustrated with meaningful use regulations and with electronic health record (EHR) systems that don't help physicians take care of their patients or achieve success in a number of government programs.
Thus, the Academy wasted no time in evaluating and responding to CMS' final rule -- covering the Medicare and Medicaid EHR Incentive Programs and stage three of meaningful use regulations -- as published(www.gpo.gov) in the Oct. 16 Federal Register.
In a Dec. 2 letter(3 page PDF) to HHS Secretary Sylvia Burwell, AAFP Board Chair Robert Wergin, M.D., of Milford, Neb., said the Academy shares the agency's desire to achieve practice and payment transformation and to move the health care system toward the lofty goals of the "triple aim" -- improved care, better health and lower health care costs.
However, he expressed great concern that the final rule fell far short of expectations and, in fact, placed "further obstacles in the path to this goal."
Wergin cited a 27 percent decrease in physician satisfaction with their EHRs since the launch of the meaningful use program. He pointed to CMS' own data as evidence of declining participation in a program that experienced a serious backslide in growth (negative 11 percent) from 2013 to 2014.
In fact, said Wergin, some of the most enthusiastic early adopters of EHR have dropped out of the program.
"These statistics -- and the palpable frustration in the EP (eligible professional) community point to a program in crisis," said Wergin. And unfortunately, implementation of stage three will only exacerbate the program, he added.
Some of the problem lies with the EHR vendor community that, since 2010, has devoted most of its research and development resources toward acquiring the components necessary for meaningful use certification and leaving the EHR functionalities physicians need to achieve value-based payment "on the back burner."
Interoperability is moving at a snail's pace, said Wergin, leaving the AAFP "deeply concerned" that family physicians will not be successful in the value-based payment environment outlined in the Medicare Access and CHIP Reauthorization Act (MACRA) and stamped with a 2018 deadline.
"Physicians face significant challenges with their EHRs and in meeting current meaningful use standards," said Wergin. "Until the meaningful use program is improved and the EHR issues are resolved, it is difficult to foresee a large percentage of physicians -- particularly physicians in small and independent practices -- being successful in MACRA programs.
"EHRs should be a tool for success in a physician's practice, not an obstacle to overcome," he added.
Wergin called on HHS to "transform" the entire meaningful use program rather than merely "tweak" stage three requirements.
He urged CMS to hit the pause button on meaningful use long enough to allow
- the health care industry time to focus on interoperability issues;
- vendors, physicians and other health care professionals time to focus on designing and implementing the functionality and workflows necessary to achieve value-based payment; and
- regulators time to modify meaningful use regulations and align them with pending MACRA rules.
A heavy load of administrative burden along with a climate of constant change has overwhelmed many physicians, said Wergin.
He urged CMS to "refocus and streamline" efforts related to meaningful use and to put interoperability at the top of the list. Support the EHR capabilities physicians need to be successful in a value-based payment system, Wergin told CMS.
Related AAFP News Coverage
Tell Congress to Hit Pause on Meaningful Use Stage Three