EHRs Valuable in Implementing Maintenance of Licensure, Says FSMB

If physicians widely adopted electronic health records, or EHRs, patient outcomes could be improved at the same time clinical competence could be assessed for medical licensure. That's according to a recent announcement from the Federation of State Medical Boards, or FSMB.

The announcement came during an Aug. 5 Washington, D.C., forum, "Advancing Electronic Health Records Adoption and Meaningful Use," hosted by the Health Industry Forum of Brandeis University in Waltham, Mass., and Health Affairs.

"As the Federation of State Medical Boards works with its member boards in the months and years ahead to implement Maintenance of Licensure, it is clear that electronic health records will be of value as doctors fulfill that professional obligation and demonstrate ongoing clinical competence," said Humayun Chaudhry, D.O., president and CEO of the FSMB, in a press release (2-page PDF; About PDFs) recapping the event.

The FSMB, which represents the 70 medical boards throughout the United States and its territories, made the announcement four months after its house of delegates approved a framework for Maintenance of Licensure (8-page PDF; About PDFs), or MOL, that recommends physicians, as a condition of license renewal, "should provide evidence of participation in a program of professional development and lifelong learning."

According to the federation's MOL framework, physicians should continually engage in three types of activities:

The activities should be practice-relevant; informed by objective data sources, such as practice data; and required of all licensed physicians. The first and third components of MOL, reflective self-assessment and demonstration of performance in practice, would be most affected by physicians' adoption of EHRs.

"Once Maintenance of Licensure is implemented by state medical and osteopathic boards, it should encourage and support lifelong learning by physicians and create a system to confirm practice improvement efforts," Chaudhry said in the press release.

"This will be a challenging task and will require collaboration and cooperation across many sectors of the health care system. At the very core of this effort will be the need for a robust system of data and information exchange -- exactly the kind of infrastructure that has been envisioned by proponents of electronic health records," he added.

As outlined in the framework document, the reflective self-assessment component of MOL -- which addresses physicians' obligation to commit to lifelong learning to maintain their skills and acquire updated knowledge -- could involve the use of an assessment tool, such as an accredited CME pretest, to identify areas for improvement, followed by completion of an improvement activity.

The second component, assessment of knowledge of skills, would not require passing a new examination. State licensing boards, however, will need to consider options for physicians to demonstrate ongoing clinical competence, such as computer-based clinical simulations and hospital procedural privileging.

For the third component, performance in practice, physicians could use data derived from their own practices, supplemented by practice improvement activities being implemented by specialty societies, hospitals, physician groups and quality improvement organizations. The performance-in-practice component is closely tied to the adoption of EHRs, the document says.

"By utilizing health information technology, physicians under MOL could continually improve the care that patients receive from them, could better understand the impact of their care on patient outcomes and bring their practices in line with the latest medical research," said Freda Bush, M.D., chair of the FSMB Board of Directors, in the press release.

"It would also enable physicians to use real-time comparative practice data to guide ongoing practice improvement efforts," she added.

An FSMB-sponsored MOL Implementation Group is discussing the framework and is expected to produce a draft report that outlines options for state boards. An MOL pilot may be initiated by state medical and osteopathic boards by the end of the year.