The College has been fortunate to represent the subspecialty of allergy in the American Medical Association’s (AMA) House of Delegates for more than 25 years. We have made our voice heard in countless decisions from resolutions that affect all of medicine to new allergy CPT codes and/or definitions.
Every five years, the AMA reviews national specialty societies for continued representation in the House of Delegates. Our review will take place in early 2019! If 20% of College members are not AMA members at the time of the review, we will lose our seat and our voice in decisions. If you are not currently an AMA member, we urge you to join the AMA today!
If you’re on the fence about AMA membership, read on to see just one way the AMA is working for you.
Many physicians blame EHR’s for their burnout and frustration with medical practice. The electronic system was supposed to improve patient data entry, communication between physicians and clinical decision-making. But instead, physicians have found the systems are counterintuitive, hard to navigate, difficult to adapt to unusual clinical situations, very expensive – and take up too much physician time. Most systems are good at billing and electronic prescribing, but not much else. However, the U.S. government and insurance companies have come to rely more and more on them.
Computers have been used for health data recording for at least 30 years, but by 2008 only 20% of physicians were routinely using them in the medical office. The insurance companies, large medical systems and the government all joined together to change that. By 2009, Medicare began a system of “reward and punishment” to promote EHRs. By 2014, 80% of U.S. hospitals and office physicians were using an EHR. The Robert Wood Johnson Foundation estimates initial costs at about $180,000 for an average medical group and staggering maintenance costs of $85,000 per year. A survey of family physicians found their EHR required about one extra hour of clinic time per day.
The AMA began to confront the EHR disaster with a set of principles:
- Enhance physicians’ ability to provide high-quality patient care
- Effective communication and engagement between patients and physicians should be of crucial importance in EHR design.
- It should fit seamlessly into the practice and not distract physicians from patients.
Furthermore, the AMA stresses that EHR design and configuration must:
- Facilitate clinical staff to perform work as necessary and to the extent their licensure and privileges permit.
- Allow physicians to dynamically allocate and delegate work to appropriate members of the care team as permitted by institutional policies.
- Promote care coordination. EHRs should have enhanced ability to automatically track referrals and consultations as well as ensure that the referring physician is able to follow the patient’s progress and activity throughout the continuum of care.
- Offer product modularity and configurability. Modularity of technology will result in EHRs that offer flexibility to meet individual practice requirements. Application program interfaces (APIs) can be an important contributor to this modularity.
- Reduce cognitive workload. EHRs should support medical decision-making by providing concise, context-sensitive and real-time data uncluttered by extraneous information. EHRs should manage information flow and adjust for context, environment and user preferences.
- Promote data liquidity. EHRs should facilitate connected health care interoperability across different venues such as hospitals, ambulatory care settings, laboratories, pharmacies, post-acute and long-term care settings. This means not only being able to export data but also to properly incorporate external data from other systems into the longitudinal patient record. Data sharing and open architecture must address EHR data “lock-in.”
- Facilitate digital and mobile patient engagement. Whether for health and wellness or the management of chronic illnesses, interoperability between a patient’s mobile technology and the EHR will be an asset.
- Expedite user input into product design and post-implementation feedback. An essential step to user-centered design is incorporating end-user feedback into the design and improvement of a product. EHR technology should facilitate this feedback.
The AMA is also working with 32 U.S. medical schools to include medical student teaching modules in EHR usage. In addition, the AMA is pushing vendors for fair and open pricing, for no vendor data blocking, and for EHR interoperability.
As you can see, the AMA is hard at work improving the utilization of EHR’s on behalf of all practicing physicians and thus restoring some sanity to medical practice. We need all allergists to support the AMA with our membership.