60% of MA Docs Will Not Meet Ch224 Electronic Medical Record Mandate

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broken_cablePutting aside a lengthy discussion about the merits of and cost saving of EMRs for a minute, comes this gem from the land of not so well thought out policy making…

In 2010, the Massachusetts Legislature passed a law requiring that, as a condition of licensure starting in 2015, Massachusetts physicians must demonstrate proficiency in the use of electronic health records, computerized order entry, e-prescribing, and other forms of health information technology.

Last year [ in chapter 224], the Legislature amended that statute to state that physicians must “demonstrate the skills to comply with the ‘meaningful use’ requirements.” There was no further language to explain the intent or scope of that amendment.

Given that even the most optimistic forecast holds that only 12,000 eligible providers in Massachusetts would achieve Meaningful Use certification by 2015 (more than 30,000 physicians hold a Massachusetts license), the MMS is committed to ensuring that the statute is interpreted broadly, and does not unintentionally disenfranchise thousands of physicians, thereby creating an extreme health care access issue.

-Massachusetts Medical Society

So 60% of doctors are projected to be non-compliant?!? I guess a doctor shortage will take on a whole new meaning in the state.

This is what happens when you pass major policy bills in 14 hours without anyone reading the whole thing first, but I digress…

This issue prompted a recent call to action from a local doctor in North Chelmsford, Dr. Hayward Zwerling.

The EMR Use Rule: An Open Letter to Massachusetts Physicians


Last summer, the Commonwealth of Massachusetts enacted legislation that will fundamentally alter the physician-patient relationship by giving politicians the right to specify the processes that must occur during an office visit. The relevant law is Section 108 of Chapter 224 of the Acts of 2012, which reads as follows:

The first paragraph of section 2 of chapter 112 of the General Laws … is hereby amended by inserting (the following)… The board (of Registration in Medicine) shall require, as a standard of eligibility for (medical) licensure, that applicants demonstrate proficiency in the use of computerized physician order entry, e- prescribing, electronic health records and other forms of health information technology, as determined by the board. As used in this section, proficiency, at a minimum shall mean that applicants demonstrate the skills to comply with the “meaningful use” requirements(1).

 Thus, any Massachusetts physician who does not use a Federally certified EMR AND meet the contemporary Meaningful Use requirements will be denied a license to practice medicine effective 2015. Most unfortunately, the Meaningful Use mandates will continue to become ever more onerous in Stages 2, 3, 4, 5, 6 and 7.

As we all know, the practice of medicine has become increasingly difficult as a result of external mandates. These mandates specify which medicines we may prescribe, which radiology tests we can order, how many days our patients are allowed to remain in the hospital, which CME classes we must take, etc. And now, the politicians intend to tell physicians which software they must use in their office and which EMR options must be utilized during the office visit.

The Government’s decision to foist “certified” EMRs on the medical profession is predicated on the hypothesis that the widespread adoption of EMRs will eventually reduce the cost of healthcare. Unfortunately, data published to-date does not support this hypothesis (2). Thus, the continued imposition of the EMR mandates will only delay the implementation of a truly effective solution that could reduce the cost of healthcare.

As the developer of an EMR, I sincerely believe that a well designed EMR is a useful tool for many practices. However, the Federal and State Government’s misguided obsession to stipulate which features must be in the EMRs, and how the physician should use the EMRs in the exam room places the politicians in the middle of the exam room between the patient and the physician, and seriously disrupts the physician-patient relationship. It is past time that physicians reclaim control of their offices, if not the practice of medicine.

It is past time that physicians reclaim control of their offices, if not the practice of medicine. I strongly encourage all Massachusetts physicians you to contact Governor Deval Patrick, Secretary of Health and Human Services John Polanowicz, your Massachusetts state Senator and Representative and ask them to rescind Section 108 of Chapter 224 of the Acts of 2012. Also tell the politicians to desist from interfering in the physician-patient relationship, which is a prerequisite for high quality healthcare. Please feel free to forward this letter to your colleagues. I also encouraged you to plagiarize this letter, as needed, for your communication to your state representative.

Hayward K. Zwerling, M.D., FACP, FACE is an a board-certified internal medicine physician who specializes in endocrinology. He practices at the Lowell Diabetes & Endocrine Center in North Chelmsford, MA. Zwerling is also the president of ComChart Medical Software, LLC.