A few years ago, physicians were typically viewed as one of the main stumbling blocks to IT implementations. In recent months, the American Medical Association is doing its best to eradicate that impression.
For a physician organization, the AMA is spending a lot of time in technology circles, so much so that earlier this month, Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, complimented the AMA for its "great advocacy" when he made his announcement that the federal Meaningful Use program will be replaced in 2016.
That same day, the AMA announced it was launching a healthcare innovation company called Health2047, which will conduct rapid exploration of innovative solutions, including some in information technology.
The genesis for the association's increased involvement in health IT goes back to a 2013 AMA-RAND study on physician satisfiers and dis-satisfiers, says Steven J. Stack, MD, the AMA's president.
"Doctors are most fulfilled when they feel that their work has helped patients lead healthier, happier lives, and when they feel that the health system supported them in that work," Stack says. "Right now, doctors often feel under siege and impeded by all sorts of things that intrude on the patient-physician relationship."
Poor IT usability and interoperability are looming as chief intrusions for the medical community. Other impediments include a lack of resources to fuel innovations in patient care and micromanagement from private and public payers.
One of the AMA's strategic goals is to improve physician practice sustainability. "We are working very aggressively to create what we describe as an innovation ecosystem," Stack says. "We are trying to help physicians thrive and innovate in their offices so they can be more efficient and spend more time with patients."
While there’s more to this goal than health IT, the AMA is investing considerable resources to ensure that physicians' IT concerns are kept front and center.
"We're getting deeply involved in the health IT space," asserts Michael Hodgkins, MD, who has served as the AMA's chief medical information officer for the past five years. "We want to make sure that the physician voice is represented in how these tools are developed. The promise of HIT lies in its ability to overcome the limitations of a very fragmented healthcare system."
Improved interoperability and usability are the association’s primary IT objectives, Stack says. "Electronic health records and other technologies are not elegantly designed right now. It’s akin to giving physicians—who have seven or more years of post-graduate education—Apple IIe computers to work on while everyone else is using iPhones."
The AMA is hosting a series of town hall meetings across the country to gain physician input on how to improve EHRs. Plus, physicians can post their EHR frustrations at breaktheredtape.org. The growing volume of physician input is informing conversations that the AMA is seeking out with various health IT players, ranging from government officials to EHR vendors and trade organizations, on how to improve EHRs.
The federal Meaningful Use program has been standing in the way of needed innovation, Stack suggests. "There’s a desperate need to pull back on the over-burdensome requirements and how the program mandates exactly how all doctors in all settings must do certain things. The program needs to be far less prescriptive and allow more innovation to occur, which means it has to stop micromanaging so many facets of the experience."
Physician frustration with Meaningful Use is reflected in participation rates, the AMA contends. While 54 percent of physicians participated in Stage 1 for at least one reporting period, fewer than 10 percent participated in Stage 2, according to data in a recent AMA report.
The AMA was grateful to hear Slavitt say the program will be revised in 2016, Stack says.
"We're cautiously hopeful that we’ll be able to continue to work with CMS as it puts forward regulations for the new Medicare physician payment structure," he says. "As we do that, we hope to fundamentally change and recalibrate the EHR component so it leaves much more discretion and choice to the physicians in their selection of these tools and how they use them, and focuses much more on patient outcomes we are hoping to achieve."
The AMA's launch of Health2047 helps further the association's interest in spurring "innovation in the private sector that is more vibrantly responsive to physician input and concern," Stack says.
The for-profit San Francisco idea lab aims to identify, design and market out-of-the box solutions to challenging healthcare problems. AMA invested $15 million in the startup and is currently identifying potential partners to collaborate with on promising ideas. "We have cast a wide and big net in hopes that we find the best possible ideas," Stack says.
In a related move, the AMA is also partnering with MATTER, an independent healthcare innovation accelerator in Chicago, located less than a mile from the AMA headquarters. MATTER has brought together more than 100 healthcare technology startups. The AMA has a studio in MATTER’s Chicago workspace that enables physicians to work one-on-one with entrepreneurs in developing promising digital technologies.
"Mobile and digital health are clearly going to transform the way healthcare is provided," Stack says. "Our interest is not to make something glamorous and glitzy. We are trying to find solutions that will make the clinical experience better for patients and physicians."
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