As many readers know, the state of Massachusetts will soon require doctors to prove that they’re at least minimally EMR-savvy. By the year 2015, doctors will need to be able to demonstrate that they’re competent in EMR use to maintain their license, and apparently, having CME credits in this area counts as “proficiency.”
While there’s no guarantee, my guess is that most or all of the other state governments will take a similar tack. After all, the federal government has thrown its weight behind EMR use and imposed standards (Meaningful Use) demanding that clinicians generate some value from their system. If I were in state officials’ shoes, I’d want to get on the bandwagon before I was forced to adopt federal rules on this subject. (I’m also betting on the spread of the Mass approach simply because the state is a trend-setter.)
In theory, this is a good idea. Nobody wants to see themselves or someone they care about harmed because their doctor didn’t know how to enter data, where to click or whether they’re looking at the right allergy list, just to make up a few random issues. And while CME courses aren’t perfect, they can at least be standardized to make sure everyone’s at a known minimum level of expertise.
That being said, this approach has some drawbacks, none of which are trivial.
For one thing, I’d argue that doctors don’t need to be brilliant EMR users so much as skilled EMR thinkers. In other words, doctors need to know how to leverage their EMRs to improve patient health, to detect possible issues such as medication mix-ups and streamline clinical data sharing, not just get through a clinical interview screen compentently or figure out e-prescribing. If states are going to get involved with the EMR education process, why not go for higher-level training which can actually improve patient care over the long term?
Another concern I have is that while CME courses may provide excellent training in core EMR skillsets, there’s no such thing as a single “EMR system.” With (depending on who you believe) anywhere from 300 to 1000+ EMRs on the market, physicians can’t possibly learn everything they need to know from a single course. While some may adapt to their own EMR’s idiosyncrasies faster, others with CME credit may develop a false sense of confidence or simply burn out when they find out how much more they need to learn.
Last but not least, I’d hate to see EMR training go down the pharma path. Right now, of course, pharmas arguably buy doctor loyalty by sponsoring CME courses lavishly. If doctors need CMEs in EMR use to keep their license, big EMR vendors with fat wallets (or even the pharmas) will step in and pay for them, a process which could eventually hand the market to the best-funded rather than the most sophisticated EMR product.
Truthfully, my arguments are probably in vain. My prediction is that CME courses for EMR use will eventually be required here, there and everywhere in the U.S. I’m just hoping that a more robust model for training doctors emerges; this one may shortchange everyone involved.