Despite the ongoing and concerted advocacy efforts by medical specialty societies to influence the final meaningful use regulations, it is clear that the rules still do not offer much for specialists. I am glad to see that professional organizations are speaking out—issuing statements and providing advice to their members about the particular challenges that the current meaningful use rules pose for specialists. They agree that the right EMR offers physicians and their patients undeniable benefits and they encourage EMR adoption, but the growing consensus is that the government’s program is still defined in a way that is only meaningful for providers of primary care.
The latest group to document its concerns is the American Academy of Orthopaedic Surgeons (AAOS). Discussing the EMR Position Statement, published in the August issue of AAOS Now, EMR Project Team leader, Thomas C. Barber, M.D., warns that “Orthopaedic surgeons will have great difficulty in meeting the current 25 meaningful use standards.” The Statement maintains that “it is essential for the successful development of meaningful use standards and EHR systems certification….to recognize the different needs and uses of EHR by disparate medical specialties, especially the differences between surgical specialties and primary care specialties,” implying that to-date this has not been accomplished.
I expect that other medical societies have issued—or will issue—similar statements. As I have mentioned in previous posts, the problem for specialists is not just that the meaningful use measures are primary-care-related, but also that the EMR certification criteria are primary-care-driven. AAOS has it right when it concludes in its Position Statement that “Many systems are geared toward primary care medical practice, which can limit the utility of EHRs for specialty surgical practice.” Such systems are not productivity-focused and don’t address the specific needs of specialists. The bottom line is exactly what the academies are advising, and what I have been encouraging physicians to do all along: evaluate and adopt an EMR based on its ability to help your practice accomplish your specific goals.
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The Feds don’t care what we say on this issue apparently, and are more interested in the medical informatics they’ll be able to capture from millions of networked EMR’s then on actually affecting health care delivery on an individual practice’s basis. This will never be revenue neutral for practices as we won’t be able to ethically or honestly recoup the E&M charges to overcome the productivity drag.
Evan, thank you for your continued highlighting of this issue.