American College of Physicians issues recommendations for Meaningful Use

ACP concerned about appropriateness, unintended consequences, and costs of some proposed measures

PHILADELPHIA, September 12, 2013 -- An aggressive timeline combined with overly ambitious objectives may unnecessarily limit the success of the entire Meaningful Use EHR Incentive program, the American College of Physicians (ACP) warned today in a letter to the Department of Health and Human Services, Centers for Medicare & Medicaid Services, and National Coordinator for Health Information Technology.

ACP recommends that requirements become less prescriptive to allow eligible professionals of all specialties to be creative in applying the technology to the unique characteristics of their practice, specialty, and patient population.

"ACP supports the guiding principles of Meaningful Use to help physicians deliver quality, patient-centered care," said Michael S. Barr, MD, MBA, FACP, who leads ACP's Division of Medical Practice. "However, the reliance on evolving and draft standards, technologies for which integration is not yet completely tested, developing infrastructure, and upcoming regulatory requirements add complexity and uncertainty for physicians."

ACP's letter addresses specific concerns in five areas: the Stage 2 Meaningful Use timeline, clinical quality measures, ICD-10 and Physician Quality Reporting System (PQRS), scoring Meaningful Use measures, and planning for Stage 3 Meaningful Use.

Stage 2 Meaningful Use Timeline
ACP supports providing more time for providers to begin their reporting on Stage 2 measures given that system certification and vendor implementation issues abound.

Clinical Quality Measures
ACP says there has not been sufficient time either for the new e-measures to be tested and validated or for a determination if the output of the EHR systems is an accurate representation of the performance of the EPs.

ICD-10 and PQRS
ACP cautions that 2014 will be a difficult and frustrating year for physicians no matter what happens with Stage 2 Meaningful Use since every practice will be using ICD-10 and will need a new or updated EHR system ready to go on January 1, 2014 in order to meet the data collection requirements for PQRS and combined PQRS/EHR Incentive reporting using e-measures.

Scoring Meaningful Use Measures
ACP supports switching to a scoring system that recognizes the differences in practices and the differences between incentives and penalties and recommends "moving to a partial scoring or tiered system in Stage 2 with a higher score required for an incentive and a lower threshold required to avoid a penalty."

Planning for Stage 3 Meaningful Use
ACP urges a focus on activities that have a true measurable outcome on quality, safety and value of care, rather than a system that creates an unnecessary administrative burden that does not directly impact real practice improvement.

About the American College of Physicians
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 137,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.