With #FixEHR, AMA fine-tunes its Meaningful Use reboot strategy

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The American Medical Association (AMA) has kicked its fight against poorly operating electronic health records and the Meaningful Use program up a notch, in a rather novel way.

Increasingly frustrated by the lack of progress with the Office of the National Coordinator for Health IT and the Centers for Medicare & Medicaid Services--even after creating its own usability framework and blueprint to improve the Meaningful Use Program and increasingly more blunt language to the feds--the AMA has launched a new effort to attempt to effect change, this time by providing individual physicians with a national platform to voice their experiences so that members of Congress can hear about them.

Presented at a meeting in Atlanta on July 20 in conjunction with the Medical Association of Georgia, physicians were encouraged to "share stories" about their experiences with EHRs and Meaningful Use in order to send a "clear message" to those in policy making.

AMA President Steven Stack urged physicians to post their stories on a new website, breaktheredtape.org, and on Twitter with the hashtag #FixEHR. The AMA's goals are to improve EHR usability and workflow, and to "pause" Meaningful Use Stage 3 so that it can be aligned with other payment models.

The website enables physicians to provide either written testimony or a YouTube video, and to send it to their Congressman.

This is pretty clever. It's a grassroots campaign that takes advantage of high tech.

There certainly was no holding back on the part of the physicians attending the town hall, many of whom were very vocal about sharing their frustrations. Productivity was down dramatically, administrative burdens were higher and the lack of interoperability is a major patient care concern.

One physician said that he retired because of his frustrations with EHRs. At least two reported dropping out of the Meaningful Use program and taking the Medicare penalty. One couldn't meet Meaningful Use because her vendor was still not capable of doing so. Another pointed out that she now has to go through reams of information to look for two sentences buried in the record.   

All were worried about increased liability, security issues, having to treat fewer patients a day and the negative impact on patient care. One physician said that penalizing physicians who refuse to use the EHRs until the problems are fixed was unconstitutional.

There were so many who wanted to share their stories that Stack extended the town hall, already 90 minutes long, for an additional 30 minutes.

What they reported wasn't new. But these were real people, with personal stories. You could see and hear their frustration.

There have been numerous surveys that have reported physicians' dissatisfaction with EHRs and the Meaningful Use program. But it's easier to ignore anonymous physicians in a survey. It's different when physicians are identifying themselves and sending YouTube videos. The Congressmen will also be able to see and hear the frustration.

Some of the things the physicians said I found particularly striking, such as the fear that EHRs were being used as "blunt tools" to acquire practices; that physicians will end up seeing fewer Medicare patients; and that there's too much onus on interoperability on the provider, when the onus should be really on the vendor.

"We have a technology that brings graduate degree-educated people to their knees. There's something not right here," Stack said.

The real question is whether this campaign will work. It may have been more useful earlier, before so much money and time was invested in these systems and before we hit Stage 2 of the Meaningful Use program.  

Rep. Tom Price (R-Ga.) recognized that, noting at the meeting that "time is running very very short."

And there's no telling whether policy makers will pay attention.

But a wellspring of storytelling by thousands of doctors could have a collective impact. Congress certainly has been more involved in the Meaningful Use program and interoperability issues in recent months. And while ONC and CMS are somewhat insulated in the executive branch of government, Congressmen and women are elected officials. And physicians vote.

Plus, the AMA knows that if you don't let up, you may just get what you're fighting for, something Price had no qualms about pointing out.

"Remember, if it's a challenge, remember SGR. There is a light at the end of the tunnel and it's not necessarily an oncoming train," he said. - Marla (@MarlaHirsch and @FierceHealthIT)

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