AMA: MU Secure Messaging Criteria Should Be Optional

The Centers for Medicare and Medicaid Services (CMS) should make the “view-download-transmit,” transitions of care and secure messaging criteria in stage 2 Meaningful Use optional, according to the American Medical Association (AMA). That was one of several suggestions in a blueprint created by the AMA last week.

In a letter to CMS Administrator Marilyn Tavenner and Karen DeSalvo, National Coordinator for Health Information Technology, the AMA said that CMS needs to adopt a more flexible approach for meeting MU. Specifically, CMS should remove the existing program’s “all-or-nothing approach” and instead adopt a 50 percent threshold for incurring a penalty and a 75 percent threshold for earning an incentive for Stages 1 to 2.

“The current program attempted to mitigate these differences by offering percentage thresholds,” the letter stated. “However, this design creates additional administrative burden – physicians must implement different workflows for different patients and engage in extensive tracking to ensure measures and thresholds are met. We believe that setting arbitrary thresholds is of little help to physicians and may lead to inconsistencies in the care provided to patients.”

In terms of secure messaging, the AMA explained that it does see the value in the practice. However, the organization thinks physicians should be able to choose whether or not to use it.

“Medicare does not reimburse for secure messaging, and while many physicians have successfully incorporated it into their workflow, many others do not use it precisely because it is an added workflow burden,” the AMA explained in its letter.

The AMA also recommended that since secure messaging is outside of a physician’s control and requires substantial effort, physicians who elect to meet this measure should be allowed to count it as meeting two measures.

Also discussed in the AMA letter was the issue of providers conducting a security risk assessment. According to the AMA, current technology cannot properly achieve this measure, and it comes with an additional cost outside of an EHR purchase. While physicians want to protect patient privacy and PHI, “there is a strong need for an education campaign for physicians to employ best practices to protect patient information.”

The level of education and training needed is also substantial, the letter explained, and most physicians do not have intricate knowledge of digital security. The AMA recommended that

CMS, ONC, and other agencies to develop and deploy training across the country to help physicians better prepare for protecting and securing PHI.

Overall, the letter called for stronger federal health IT policies that can benefit both patients and healthcare providers. The MU program must actually be meaningful and not hinder the intended improvements in patient care and practice efficiencies, according to AMA President Robert M. Wah, MD.

“Physicians should not be required to meet measures that are not improving patient care or use systems that are decreasing practice efficiencies,” Wah said in a statement. “Levying penalties unnecessarily will hinder physicians’ ability to purchase and use new technologies and will hurt their ability to participate in innovative payment and delivery models that could improve the quality of care.”