EHR Surveys Available to All Physicians
The American Medical Association and AmericanEHR Partners are teaming up to survey physicians using or planning to use an electronic health record (EHR). The survey results will help populate a growing database of EHR system rankings. In addition, the Louisiana State Medical Society (LSMS) is surveying physicians' use of EHRs.
The feedback from the AMA/AmericanEHR Partners 150-question survey will help all physicians with future EHR purchases as well as help improve the EHR industry overall. The questions use a five-level rating system that looks at various aspects of EHRs. The results are collated to assign a collective rating for each category.
The site has top 10 lists of various products based on the ratings. Only those systems that have at least 10 survey evaluations are given a collective rating score and are used in the rankings. The database is free and can be queried according to practice size. The survey should take approximately 5 minutes for non-EHR users and 20 minutes for EHR users. The TMA Ad Hoc Committee on Health Information Technology frequently discusses how physicians can benefit from EHR vendor rankings, which only improve with feedback by users. Although the survey home page says it is for AMA members, the AMA says any physician – AMA member or not – can complete it.
Surveys completed before Nov. 8 will be entered into a drawing for the latest tablet computer or one of five $100 Visa gift cards. However, members may take the survey after that date. Physicians must create an account to participate in the survey, and their professional status will be verified using the AMA's Physician Verification Service.
The new LSMS survey expands on a statewide study the medical society conducted last year. Almost 600 Louisiana physicians responded. LSMS received a Physicians Foundation grant to study EHR nonadoption among physicians nationwide. The report on the national survey will address:
- Factors that discriminate between nonadopters and adopters;
- The presence of specific regional drivers (or inhibitors) of EHR adoption; and
- The patterns of adopters that lead to meaningful use.
Physicians who take the survey are eligible to win an e-reader.
Women's Health Program Gag Rule Defeated
Responding to strong opposition from TMA and state specialty societies, Health and Human Services Commissioner Kyle Janek, MD, pulled the gag clause from rules governing the state's redesigned Women's Health Program.
As proposed by Commissioner Janek's predecessor, the rule would have prohibited a participating physician from discussing abortion with a patient. The new rule still prohibits Women's Health Program funds from going to a physician or provider who promotes or performs abortion, but the definition of "promote" was revised to exclude "neutral, factual information and nondirective counseling."
TMA President Michael Speer, MD, praised the change. "It is very important that patients are able to trust that their doctor is giving the best medical advice for them – based on their medical needs and nothing else," he said.
TMA remains concerned for the program's long-term viability – and for the women it serves – as the state next month tries to run the program on its own without $35 million a year in federal funding.
On Oct. 31, the Texas Tribune reported that the revised Women's Health Program would not launch on Nov. 1, as the state had planned, until the legal battle over including Planned Parenthood in the program is resolved. But the Austin American-Statesman said Gov. Rick Perry announced the state is ready to begin the program without Planned Parenthood when the federal government stops funding for the contraceptive and preventive care program for low-income women.
After Texas legislators excluded Planned Parenthood and other "abortion affiliates" from participating as providers in the program, the federal government withdrew funding. Planned Parenthood sued the Texas Health and Human Services Commission to remain in the program. The new rules governing the redesigned program include a "poison pill" provision, which would eliminate the program entirely if Planned Parenthood prevails in the lawsuit.
Organized Medicine Seeks Medicare Reform
TMA joined the American Medical Association and 108 other state and specialty medical societies in urging Congress to not just repeal the flawed Medicare payment formula, but to replace it with a system grounded in a set of core principles essential to creating a "high-performing" Medicare program.
Although it wants the Sustainable Growth Rate (SGR) formula eliminated, "the physician community recognizes that this is only one-half of the equation," the groups say in an Oct. 15 letter to the chairs and ranking members of the Senate Finance and House Ways and Means and Energy and Commerce committees. Successful delivery reform that provides patient choice also is a must, along with new payment models that reflect the expense of providing services, as well as efforts to improve quality and manage costs, they add.
The letter warns that the SGR is an "enormous impediment" to reform efforts such as patient-centered medical homes, accountable care organizations, and shared savings programs The formula does not keep up with the cost of care, and the constant threat of steep cuts and last-minute congressional action creates an environment of uncertainty for physicians, their senior patients, and access to care.
Medicare payments to physicians will be cut 27 percent on Jan. 1 unless Congress intervenes as it has for the last decade to stop SGR-mandated fee reductions.
The letter says physicians want to ensure a "robust transition period that can fill the gap" between eliminating the SGR and implementing a new, nationwide system. That transition plan should include elements that reflect the diversity of physician practices and give physicians the freedom to choose a model that works for their practices and patients, and encourage incremental changes with positive rewards, instead of using penalties to order abrupt changes in care delivery.
Any new system should allow physicians to take a leading role in health care delivery, while offering a way for them to measure, demonstrate, and achieve rewards for progress on quality and costs, the letter said. Among other criteria, physicians also want to see that new federal policy promotes structures that:
- Reward physicians for reducing costs;
- Tie incentives to physicians' own actions, not the actions of others or factors beyond their influence;
- Encourage systems of care, regional collaborative efforts, and primary care and specialist cooperation while preserving patient choice;
- Allow specialty and state society initiatives to be credited as delivery improvements and recognize the central role of the profession in determining and measuring quality; and
- Provide exemptions and alternatives for physician practices for which the investments necessary to reform care delivery would constitute a hardship.