The American Medical Association on Tuesday sent a 10-page letter to the Centers for Medicare and Medicaid Services recommending a host of fixes to what it called a "troubled" meaningful use program.

"Doctors want to spend their time with patients, not measuring the number of clicks," said AMA President Steven J. Stack, MD, in a statement. "We want a successful transition to digital health records, and we also want the new Medicare law to succeed. It will take thoughtful changes in the regulations to support physicians as they treat patients through new models of care."

[See also: AMA urges hitting Stage 3 pause button.]

The association, which represents nearly 225,000 members across the country, said the program needs to accommodate the needs of physicians and patients while focusing on promoting the interoperability of electronic health records.

The letter notes that the landscape has changed substantially since CMS first issued regulations for Stage 3 meaningful use. In April, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015, which adopted a new physician payment framework based on quality and value.

Transitioning to this new system requires that physicians have usable and interoperable tools that involve patients and support care coordination, AMA leaders said. Stage 3 must allow physicians to maximize the use of electronic health records in place today, while allowing vendors to continue to innovate and create new technologies.

[See also: AMA docs fed up with EHR woes.]

In the letter to CMS, AMA said that its proposed framework is not a complete redesign. Rather, it aims to work within the current systems while offering "a glide path" to meet the new law.

As the AMA sees it, program flexibility is the key factor in improving the meaningful use program, ensuring that Stage 3 objectives can align with advanced payment models. New payment systems will not work if physicians fail for missing just one of numerous requirements or are held accountable for technological failures outside of their control.

[See also: AMA presses CMS for meaningful use hardship exemption.]

"The AMA-proposed approach would also engage patients in their healthcare decisions rather than simply judging physicians on how well they transmit data," officials said.

AMA has repeatedly called on CMS to address the challenges of the meaningful use program before moving on to Stage 3. The letter notes what the group has done to move forward on this score:

• Physicians have told their stories of trying to comply with the regulations as part of AMA's Break the Red Tape campaign.
• The AMA partnered with RAND on a study that found cumbersome EHR systems are taking a toll on physicians who feel increasingly demoralized by technology that interferes with their ability to provide first-rate medical care to their patients.
• Also, to leverage the power of EHRs for enhancing patient care, improving productivity, and reducing administrative costs, the AMA has outlined a framework of eight priorities for improving EHR usability.
• The AMA has also issued a blueprint for the future of the meaningful use program with recommendations to improve EHR functionality.

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