Beth Israel Deaconess Medical Center CIO John Halamka believes that less could be more when it comes to physicians transitioning to the new programs outlined under the Medicare Access & CHIP Reauthorization Act (MACRA).
For clinicians, he says in a post to his Life as a Healthcare CIO blog, less focus on striving toward multiple quality indicators and more emphasis on an important but select few could lead to improved outcomes quality. The post is a follow-up to his earlier commentary on the MACRA proposed rules, which he calls overly complex and burdensome.
He notes, for instance, that forcing doctors like his ophthalmologist to record smoking statuses or send secure messages to patients is not as vital to better care as actually ensuring medications are administered and eyesight does not worsen.
"Keeping my sight intact represents value," Halamka says. "How software does that is not important and innovative workflow would be left to the marketplace where clinicians will choose applications based on usability, cost and time savings instead of regulatory oversight."
He suggests, instead, that each medical specialty choose three "highly desirable outcomes" to focus on annually that the Centers for Medicare & Medicaid Services then can reward.
In addition, Halamka says that technology certification could entail the "ability to perform a few key interoperability functions," including, but not limited to, looking up other clinicians via a national directory and sending clinical summaries to their email addresses securely; sending a select few data elements to relevant registries; and participating in a prescription drug monitoring program.
"How these transactions are implemented in workflow would be up to each vendor," he says. "Certification would test nothing more than successful transactions against a publicly available test bed."
Such steps, Halamka says, could help physicians avoid unnecessary burdens, adding that much of certification required as part of Meaningful Use was not related to overall federal health policy goals.
"Think of all the data entry required which resulted in clinicians spending time practicing below the top of their licenses," he says.
To learn more:
- here's Halamka's full post