Resolution 7-S16. Calling Upon the Office of the National Coordinator of IT to Improve the Clinical Utility of EMRs so that Clinicians Can Provide Optimal Patient Care

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(Sponsor: District of Columbia Chapter)

WHEREAS, a) Resolution 2-S13 was passed by the Board of Governors calling upon the Board of Regents to "endorse and actively promote documentation within the electronic medical record to improve communication…"; b) The Board of Regents adopted and referred this resolution to the Medical Informatics Committee; c) The Medical informatics Committee prepared a position paper published in the Annals of Internal Medicine ("Clinical Documentation in the 21st Century1: Executive Summary of a Policy Position Paper from the ACP") which states that "Clinical documentation was developed to track a patient's condition and communicate the author's actions and thoughts…[but] over time, other stakeholders have placed additional requirements on the clinical documentation process for purposes other than direct care of the patient; and

WHEREAS, the problems described by Resolution 2-S13 which was passed by the BOG 2.5 years ago are worsening as more physicians use EMRs leading to increasing numbers of physicians struggling to extract clinically relevant information from progress notes and discharge summaries which increases physician burden, decreases quality of medical care, and potentially increases physician liability if physicians miss important clinical information within the extensive and redundant EMR notes/documents in which key clinical data/plans are often not well delineated; therefore be it

RESOLVED, that the Board of Regents formally calls upon the Office of the National Coordinator (ONC) of IT to improve the clinical utility of EMRs so that clinicians can provide optimal patient care in an efficient way which reduces legal liability and specifically requests that the ONC of IT:

  1. Avoid certifying EMRs as meeting Meaningful Use (if not already certified as such) unless such EMRs promote communication of clinically important information in a manner that promotes safe and effective medical care by clinicians.
  2. Revoke certification for currently certified EMRs if they do not promote safe and effective communication of clinically important information by clinicians (though such certification will only be removed for future sales of such EMRs so that clinicians currently using such EMRs will not be penalized by finding that EMRs they bought in good faith are no longer certified); and be it further

RESOLVED, that the Board of Regents will ask the Centers for Medicare and Medicaid Services (CMS) to address the concerns noted above as CMS develops its plans for conversion to a Merit-Based Incentive Payment System (MIPS).