EHR vendors to D.C.: Onslaught of regulations hurting progress

The healthcare information technology (HIT) marketplace-not Congress-should solve the problems with technology to aid physicians, according to electronic health record (EHR) vendors.

“Generally, at this point, our position is that new legislation related to health IT isn’t necessary,” says Leigh Burchell, past chairwoman of the Electronic Health Record (EHR) Association, which represents 32 EHR vendors. 

Arien Malec, a vice president for McKesson Relay Health, adds that legislation from Washington, D.C., is “a blunt instrument.”

“While Congress has a policymaking role to play, true progress will come from health IT developers working hand in hand with physicians to develop and deploy solutions that will help providers to do what they do best: treat patients, and improve health outcomes,” Malec told Medical Economics via e-mail.

Neither Burchell nor Malec opposes legislation such as S. 2511, the Improving Health Information Technology Act, which the U.S Senate’s Health Education Labor Pensions Committee passed unanimously in February and sent to the full Senate. The bill aims to address many of the problems physicians have experienced with EHRs by, among other remedies, reducing the regulatory and administrative burden on physicians; prohibiting information blocking; and establishing a program to rate HIT products on such factors as security, usability, interoperability and conformance to certification tests.  

These and other elements of S. 2511, such as a provision to establish a new government-run rating system, could disrupt the efforts of EHR vendors to improve electronic health record systems, Burchell says.

Since 2009, Congress has passed numerous bills and the U.S.Department of Health and Human Services has issued dozens of regulations related to how physicians document and report data on patient care. 

“It is our sense that the healthcare industry would be best served by letting those major changes play out before any more interventions by Congress,” says Burchell, vice president of policy and government affairs for Allscripts, an EHR vendor. 

To succeed with new reimbursement methods, physicians will need their EHRs to gather, store and report data, but first changes will be needed in those EHR systems. Although Congress and CMS may think changes they make in payment programs wouldn’t affect how physicians use their EHRs, any such changes will require EHR vendors to rework their systems.

Burchell says that much of the frustration clinicians experience with EHRs stems from regulations that vendors are required to implement,such as new rules to implement CMS’ new Quality Payment Program. 

Regulations that affect EHRs can be so burdensome that some physicians choose not to participate in programs that require them to do more administrative work, says David Kibbe, MD, the president and chief executive officer of DirectTrust, a nonprofit that supports the direct exchange of patient data. Some physicians cut back or even drop their Medicare patients  completely. Whether or not they actually drop out, they are certainly weighing the advantages and disadvantages of participating, Kibbe adds. 

“The challenge for Congress is to promote interoperability but not micromanage the development of standards that could stymie the work already underway,” Malec says. 

Joseph Burns is an independent journalist in Falmouth, Massachusetts. Do you agree? Tell us at: medec@ubm.com.