House Approves Critically Needed Changes to Physician EHR Requirement

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UPDATED: March 20, 2014

Read an update about this issue here.

The Massachusetts House this week approved changes in state law that would disconnect medical licensure from a physician’s use of electronic health records. The issue has been a major focus of the MMS’ advocacy efforts this year.

Under current law, effective Jan. 2015, physicians who wish to renew their license must demonstrate that they utilize EHRs that are at the level of the federal government’s meaningful use program.

MMS President Ronald W. Dunlap, MD, has met several times this year with legislative leaders, and cautioned that if the requirement is enforced, more than 10,000 physicians could lose their license, most of whom cannot, under law, qualify for Meaningful Use incentives. The resulting impact on the health care system would be devastating.

The House language would instead require practicing physicians to demonstrate that they use “digitized patient-specific clinical information.” Practicing physicians who don’t use digitized health records would be given the opportunity to demonstrate that they know how to use such records, by a method to be determined by the Board of Registration in Medicine.

Following a recent meeting between MMS President Ronald W. Dunlap and House Ways and Means Chairman Brian Dempsey (D-Haverhill), the House approved the language Wednesday by a very wide margin.

Unfortunately, the Senate’s supplemental budget bill did contain not such language, so the matter now heads to conference committee, where Chairman Dempsey has indicated will be a strong advocate for the substitute language.

We’d like to extend a big thank you to Chairman Dempsey and the House of Representatives for their actions this week.

  1. Bill Ryder says:

    Fair question, Dr. Katz. There was no public hearing or debate on this language. It was added to a 350 page health care finance reform bill with hundreds of separate issues. This legislation was written in committee and was brought to the floor of the Senate and House where it was quickly passed with very little debate or amendment to any of the hundreds of different specific requirements it contained. We were there during the process, meeting with Committee chairs and asking individual legislators for their support during the days and evenings when the bill’s adoption was pending. The MMS did work very hard in the House and Senate to get the language on meaningful use removed. We also asked the Governor to oppose this section. We were not successful primarily through the commitment of the Senate to insist on including this provision.We have been working hard since then to get the section repealed or at least, substantially revised to avoid disenfranchising thousands of physicians. We have also been working with the Board of Registration in Medicine to implement the law, which they must if it remains unchanged, in a manner that is as logical as possible. Look to future communications from the MMS on how you can support our efforts in this area.

  2. Michael H. Katz, M.D. says:

    Mr. Ryder: Where was the MMS when this bill was in legislation. Why didn’t the organization fight it before it became law.

  3. robert m. levin, m.d. says:

    There’s just too much Kafka-esque absurdity in this law; another example how the aim of Mass bureaucrats is to control docs rather than improve the quality of medical care or availability of it.
    First, this law emphasizes meaningless form over substance – that the quality of doc’s care or the note recording it matters less than the medium in which it’s written. Is this not unlike: “Chicago Cubs Lose Again – But, New Uniforms Look Great!”
    Second: Above comments about retired docs are certainly relevant. But, what about purely research or academic docs?? If Jonas Salk were doing research in Massachusetts today, here’s the Globe headline: “Unlicensed Massachusetts Doctor Wins Nobel Prize!!”

  4. Bill Ryder says:

    The Board of Registration in Medicine did not create this requirement. It is legislative in creation. Senator Richard Moore included it in a 350 page health care reform bill, Chapter 224 that passed in 2012. The language the MMS has put forward , supported by Representative Brian Dempsey will sever the connection between licensure and federal meaningful use standards. The Senate oppposes this language. Senator Stephen Brewer is representing the Senate in determining whether to adopt the House provisions in conference.. Please urge him to supportThe Mass Medical Society strongly urges your support for H.3903, the House supplemental budget, Sections 4, 13, 16,and 40 relative to physicians use of electronic health records. His contact information is State HouseRoom 212Boston, MA 02133Phone: 617-722-1540 Fax: 617-722-1078 Email: Stephen.Brewer@masenate.govDistrict OfficeTatman House20 Common Street Barre, MA 01005 Phone: 978-355-2444

  5. Henry Tulgan says:

    And what about those of us who are not seeing patients but are required to be licensed in our administrative roles?

  6. Thomas A. Morris, M.D. says:

    Since when does meaningless use of EMR dedicated to creating a huge data dump of irrelvant and redundant data for billing and legal purposes have anything to do with medical licensure and the ability to practice medicine? I do so only because I am forced to in order to get paid in a somewhat timely manner. It has nothing to do with my competence and reduces my productivity by 30%!

  7. MMS says:

    Dr. Finkelstein, It’s difficult to say at this point. Please stay in touch with this website and our email newsletter as events unfold. We hope and urge that there will be exceptions created for individuals like yourself.

  8. Michael H. Katz, M.D. says:

    I am very concerned by the Board of Registration of Medicines requirement of utilizing EHRs at the level of the federal government’s meaningful use program. Although I appreciate Dr. Dunlap’s efforts in changing this requirement, the above proposed changes would still be problematic for me and I imagine physicians similar to myself.
    As a psychiatrist I believe EHR has little place in my office. It goes against all the principles of confidentiality that I was trained with. I feel it is unfair to expect physicians to adopt EHR when they are ethically opposed to it. To tie it to licensure is therefore inappropriate. In fact it is because of the government mandate regarding EHR that I have withdrawn from being a Medicare provider.
    I would propose that there be a remedy for physicians who were either trained before computers were part of their training, or for those who are ethically opposed to EHR. I would suggest that physicians who completed medical school before 2000 or certainly before 1995 be grandfathered and exempt from having to prove they know how to use EHR. I would also propose that people who find EHR unethical be exempt.
    I hope that the MMS will give my suggestions serious consideration, and I would be more than happy to discuss my views with a representative of the organization.

  9. Dinesh says:

    Leadership at MMS , State house and BOM
    That is wonderful news for all
    This illustrates the point that partnership for positive act is possible
    Let us urge the health care providers to join MMS as their concerns and political advocacy has made this possible and more can be done
    Thank you
    Best wishes
    Dinesh

  10. frank finkelswtein md says:

    I am retired but wish to keep my license. ?what to do?

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