EHRs: Another state goes down the mandate road

Massachusetts lawmakers want to make getting a medical license hinge on a clinician’s ability to use an EHR by 2015. Physicians there have mixedfeelings about the plan.

The licensure requirement is part of a jumbo healthcare reform bill introduced in the Massachusetts state senate last month. The legislation also mandates that all hospitals and community health centers implement interoperable EHRsby 2015.

Where physicians stand in this EHR mandate is cloudy. Although some news accounts have described the legislation as requiring EHRs for all healthcare providers, the wording of the bill on this point omits any reference to physicians. A spokesperson for state Sen. Therese Murray, the bill’s sponsor, acknowledges that the mandate technically applies to just hospitals and community health centers, but says that getting physicians to adopt the technology by 2015 isstill the goal.

The requirement to make physician licensure contingent on clicking a mouse in an exam room is more defined. According to the legislation, the state medical board “shall require, as a standard of eligibility for licensure, that applicants show a pre-determined level of competency in the use of computerized physician order entry, e-prescribing, electronic health records and other formsof health information technology.”

To help doctors and other providers meet these various goals, the legislation calls for funding technical assistance and software acquisition  to the tune of $25 million a year. All state-subsidized software must be certifiedby the Certification Commission for Healthcare Information Technology.

While applauding the pursuit of EHRs and the promise of IT dollars, the Massachusetts Medical Society is worried that the bill could still place an onerous burden on its members. In state-senate testimony, the society warned that "the cost of  implementing EHRs as well as the training of physicians and staff to achieve the desired level of competency would be seen as an unfunded mandate that would make physicians less likely to come to Massachusetts and would discouragephysicians already here to remain in practice.”

Last year Minnesota enacted a law requiring physicians and other healthcare providers to  deploy interoperable EHRs by 2015. This deadline appears to roughly align with President Bush’s stated goal of most American havingan EHR by 2014.