Wednesday, July 2, 2008

The AMA on EMRs

Technology is a repeated refrain in the ongoing national health care dialog. The virtues are well known, especially to readers of this blog. Studies have been enacted by numerous foundations and organizations that show the massive savings of both money and time that electronic medical records (EMRs), properly implemented, can provide. By the same token, the discussion of EMRs also brings up a consistent set of issues that are of concern to medical providers: cost of implementation, privacy issues, and technical standards.

Thanks to the online edition of AMedNews, we can take a look at the American Medical Association's views prior to the hard copy's release date of July 7, 2008, addressing this triple header of concerns.

On standards:

As work continues to develop a national strategic plan for health IT, including any coordination of the multiple government initiatives already under way, it is essential that doctors have a strong voice. It is physicians, after all, who will be expected to invest heavily in making the system work.
The AMA also stresses that physicians with small practices should be given a voice in this discussion since they comprise the majority of medical practices in the United States. This push for standards, compatibility and systems thinking is one that is at the core of George C. Halvorson's approach. Involving the actual physicians in the crafting of these standards is extremely important. After all, they will, as pointed out above, be footing the bill.

On privacy:
To boost confidence in an integrated network, the Health Insurance Portability and Accountability Act's privacy and security rules that apply to physicians, as well as other health care professionals and health plans, should be extended to any party that works with confidential health care records. This would include workers' compensation carriers, researchers, life insurance issuers, employers, marketing firms, health IT and personal health record vendors, and health information exchanges.
Doctors, says the AMA, do not need to see an expansion of their HIPAA obligations. The organization states that this would slow down transmission of patient data as new restrictions are implemented. Instead, their proposal hinges upon expanding the privacy strictures of HIPAA to apply to anyone handling this confidential data.

On implementation:
Physician reimbursements already are under intense pressure, and the Congressional Budget Office itself has released a report doubting estimates of extraordinary, health IT-related savings. It's no surprise that many practices, especially small ones, find it justifiable to avoid health IT investment. Meaningful grants, loans and other financial incentives are essential for giving physicians the financial security they need to accept and accrue the benefits of health IT.
With the cost of implementing EMRs quoted at $37, 000 per practicing physician (and that is a starting number that does nothing but increase), these sort of incentives seems to be in order. It would be a nice change from the perverse incentive standards of the modern day medical profession.

The article goes on to relate the AMA's position as it attempts to influence the U.S. Congress, which even now is deliberating the proper ways to push expansion and implementation of health information technology. Go take a look and see for yourself what your opinion is of their stance.

SOURCE: "Removing health IT barriers: The AMA advocates that federal legislation to encourage technology use should incorporate physicians' ideas, particularly in regard to technical standards, privacy and financing." 07/07/08
photo courtesy of Daquella manera, used under its Creative Commons License

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