The premise of this article just disgusts me. I must admit that I remembered the discussion of tying medical licenses to EHR adoption, but I’d forgotten that Massachusetts actually passed the EHR requirement law. The topic was again ignited by Hayward K Zwerling, MD in this Health Care Blog post. Here’s the Massachusetts law that he sites:
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).
This law, if it remains, would mean that effective 2015 any physician who isn’t a meaningful user of a certified EHR will be denied a license to practice medicine. That means 50-75% of Massachusetts doctors would lose their license to practice medicine. That’s a huge number of doctors. Can you imagine the impact?
Plus, it’s not like Massachusetts is lagging behind the rest of the country in EHR adoption. In fact, Massachusetts is one of the states with the best EHR adoption. I’m really just dumb founded that someone would be willing to propose, let along pass a law like this.
Don’t get me wrong on this. You won’t find someone that’s more interested in seeing widespread EHR adoption. I think there are tremendous benefits waiting for us once we achieve widespread EHR adoption. I just think you’re insane to think that holding physician’s licenses over their heads is the right way to do it. The very worst way to get doctors to adopt EHR is through coercion.
My gut tells me that there’s no way this law will actually go into effect. Something will have to change between now and 2015. Maybe that was the goal of the legislation. Scare people enough so that they adopt EHR and then repeal the law. That’s a terrible tactic if it’s the case. That’s a strategy that leads to even more EHR switching.
The law is in effect. However, reading the tea leaves, “demonstrating the skills” of “EHR competency” may end up meaning “taking a 2-hour CME course.”
We’re digging around and will have more reportage on this, but that was the last update we were given from state officials a couple years ago…but clearly we need to update this.
Zwerling could be right, but you’re a Vegas guy — I would give long odds on it being interpreted the way he’s reading it in his post.
Don,
They could loosely interpret it that way. Still a sad use of a CME course. The reason I think it might not is the “meaningful use” section at the end. Without that, a CME course makes more sense, but the intent of the law does seem to be that they wanted doctors using the EHR and not just taking a course on it.
I used to draft legislation for a living for our city council in DC, which is a state legislature in all but name. One of the no nos of the trade was incorporation by reference. That is, you should not put in the name of another law or standard that could change. Thus, what meant something the day it passed, could change without the legislature doing anything.
That’s what MA has done ad it’s not a pretty sight. As MU changes, the law’s requirements will change. I think that the requirement up to the MU incorporation makes sense, but with it’s anyone’s guess about what it means. Moreover, the reference, as quoted, does not define which MU it means. Someone in their legislative counsel should have caught this.
Carl,
Nice comment and good feedback. That’s a good lesson that seemed to be missed. Although, I think the whole legislation is misguided.
“Meaningful use” eventually leads to practicing the way a committee says you must practice. The Collective tells an MD he must treat Lyme disease a certain way or that he must prescribe a drug for a PHQ 9 score that exceeds the so called “depression threshold”. My God in heaven where do these idiots come from? MDs must decide if they really have an ounce of honor or courage.
[…] a year ago, you might remember the article I wrote about the Massachusetts law that would require doctors to be meaningful EHR users to have a medical license. The law was shocking then and the idea is shocking to consider even […]