Physician groups call for tech changes to MIPS

The American College of Surgeons and American Medical Association want to see the Merit-Based Incentive Payment System promote the utilization of technology other than electronic health records.

MIPS includes Promoting Interoperability (PI) reporting requirements—formerly Advancing Care Information (ACI)—which are designed to promote patient engagement and electronic exchange of information using certified EHRs. The Centers for Medicare and Medicaid Services now calls the ACI performance category PI, an effort to focus on interoperability, improve flexibility and relieve provider burden.

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However, according to Frank Opelka, MD, medical director of quality and health policy at the American College of Surgeons, PI remains the most frustrating aspect of the MIPS program for many providers.

“The category is focused too narrowly on the EHR and less on the advancement of broadly applied patient digital health information from all data sources as the original name of Advancing Care Information implies,” Opelka testified on Thursday before a House committee. “In implementing MIPS, CMS should have a laser focus on making sure that a complete view of a patient’s digital health information is available to physicians, in a useful, standardized form, when it matters most.”

Opelka pointed out that “a patient’s longitudinal care profile rarely exists in a single EHR” and that “physicians need a digital health information environment which represents the patient with enabling information from EHRs, smartphones, iPads, tablets and other available sources.”

Likewise, testifying on behalf of the American Medical Association, David Barbe, MD, AMA’s immediate past president, told lawmakers that the physician group would like to see CMS change PI reporting requirements to “attestation alone and develop new measures that utilize not only certified electronic health records, but also technology that builds on certified EHRs.”

Opelka made the case that CMS is no longer subsidizing the adoption of EHR systems and that the agency “should take this opportunity” to refocus the “original goals of using technology, and more specifically digital health information at the patient level, to improve care and lessen the focus on EHRs alone.”

He offered that PI “should focus on who is using digital health information to build a more complete patient record that is available to patients and physicians at the point of care, and how they are using this information to improve the quality and efficiency of care.”

The goal, Opelka said, should be an interoperable digital patient medical record that includes more than just EHRs but across smart devices and clinical registries for activities such as decision support, machine learning, and artificial intelligence.

“There is so much more we can do for quality and for lowering costs by leveraging digital information,” he concluded. “We have to stop thinking of EHRs and think beyond them.”