The audacity of 'nope'

If you happened to catch my Editor's Corner in FierceMobileHealthcare on Tuesday [1], you know that I made some, um, interesting observations at the American Medical Association's annual House of Delegates meeting this week, and that I plan on sharing a few more today. Even if you didn't read my piece, you likely know that President Obama came back to his hometown of Chicago to give a major address on comprehensive healthcare reform.

In introducing Obama, outgoing AMA President Nancy Nielsen listed health IT first among four positives the Republican-leaning AMA sees in the early days of the Obama administration. Then Obama himself said health IT was the start of his reform plan. "First, we need to upgrade our medical records by switching from a paper to an electronic system of record keeping," the president said. "It simply doesn't make sense that patients in the 21st century are still filling out forms with pens on papers that have to be stored away somewhere. As Newt Gingrich has rightly pointed out--and I don't quote Newt Gingrich that often--we do a better job tracking a FedEx package in this country than we do tracking a patient's health records."

If only Obama knew what was happening in the reference committees that developed the resolutions that shape AMA policy.

Following numerous complaints that the net $19.2 billion in federal funding for EMRs would not be enough to cover physician costs for installing the technology, the House of Delegates adopted a resolution stating that the rush to install EMRs by January 2011 will cause a spike in demand for IT products and services, likely driving up prices. That may be true, given that vendors have been warning of backlogs for customers who wait too long.

Delegates also took issue with the Medicare e-prescribing bonus program that passed during the Bush administration and began this year. They said the requirement that physicians write 50 percent of their Medicare Part D prescriptions electronically was too onerous, and recommended that the threshold be lowered to 25 percent. Seriously, unless you write a lot scripts for controlled substances, there's no reason why you can't approach 100 percent, particularly with e-prescribing software available for free. The AMA itself soon will offer a free e-prescribing option [2] through a portal that's currently under development.

What really got me, though, was a resolution that directs AMA leadership to tell the federal government that the EMR incentive program "should be made compliant with AMA principles by removing penalties for non-compliance and by providing inflation-adjusted funds to cover all costs of implementation and maintenance of EMR systems."

That's right, AMA delegates believe the government is out of compliance with the principles of a private organization. Talk about the audacity of "nope." - Neil [3]