Discussion of physicians' and hospitals' use of health information technology will be on the agenda when the American Medical Association's House of Delegates meets June 18-22 in Chicago, with resolutions calling for defining e-visit criteria, facilitating the certification of open-source software and slowing hospitals' transition to new IT applications slated for review.
Docs urge caution for AMA on IT mandates
Also on the docket is a trustees report (PDF) stemming from a 2009 resolution calling on the AMA to promote the adoption of a standardized electronic health-record system user interface and to advocate for a federal mandate for interoperability of EHR systems. That report concluded that such a mandate would be counterproductive at this time.
"The usability of electronic medical records and their ability to effectively integrate with clinical decision-making and work flow has not been adequately addressed to date," according to the report. "In a highly competitive marketplace, (EHR) vendors will be motivated by their customers to build new user interface designs and improve their products to provide better solutions over time. At this time, any attempts to standardize products would stifle product innovation. Just as medical practice has evolved, so will the (EHR) marketplace."
Instead, the report recommends that AMA advocate for standardizing key EHR elements, standardizing log-in procedures and continuing research into interface design that can improve the quality, safety and efficiency of healthcare.
The Illinois delegation proposed two IT-related resolutions, including one to establish criteria (PDF) for an e-visit and to "pursue necessary discussions with third-party payers for recognition and reimbursement of electronic medical patient encounters/visits."
The other resolution (PDF) proposed for consideration by Illinois doctors notes the high cost of healthcare and states that many EHR systems are "overpriced and contribute to these high costs instead of lowering them." According to the resolution, open-source software offers a lower-cost, more-interoperable solution, and the AMA should advocate for increased financial support for physician adoption of interoperable EHRs.
The Oklahoma resolution notes (PDF) that the College of Healthcare Information Management Executives has requested "to delay implementation of any further stages" of EHR and computerized physician order entry requirements. It also states that EHR and CPOE systems decrease efficiency and timeliness of care and put patients at risk.
The resolution calls for the AMA to encourage local, state and federal regulatory agencies to slow the transition to EHRs and CPOE for all hospitals, to lobby for research demonstrating the efficacy of EHR and CPOE systems and to pass any penalties for delays in implementation from providers to IT vendors.
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