CHICAGO – Coding and computers were among key concerns for physician leaders at the American Medical Association’s annual House of Delegates meeting.
Resolutions from several delegations aimed to delay or scuttle the transition to the newest incarnation of the International Classification of Diseases, ICD-10.
Alicia Ault/IMNG Medical Media
Dr. Andrew Gurman, Speaker of the House of Delegates, and Dr. Susan Bailey, Vice Speaker of the House of Delegates.
Delegates from the American College of Rheumatology (ACR) introduced a resolution urging the association to keep up its campaign to stop ICD-10 implementation, specifically via federal legislation.
Without a statement supporting delay, there is a "perception out there that the AMA has essentially caved on the issue of ICD-10," said Dr. Gary Bryant, an ACR delegate. "Now that’s not my perception, but I believe it’s the perception, to some degree, among American physicians."
The House adopted instead a resolution calling for the AMA to support federal legislation to delay ICD-10 implementation for 2 years. During that time, payers would not be allowed to deny payment based on the specificity of the diagnosis, but they would be required to provide feedback in the case of an incorrect diagnosis. The resolution was brought by the Colorado delegation.
Dr. Reid Blackwelder, president-elect of the American Academy of Family Physicians, spoke in favor of the resolution.
"It’s not likely that we’re moving from ICD-9, we are." Instead, the resolution "allows our members to have a period of time to get used to the sticker shock," he said.
The AMA has estimated that the cost of implementing ICD-10 could range from $83,290 to more than $2.7 million per practice, depending on practice size.
Delegates also sought to slow the adoption of electronic health records, citing major problems with interoperability.
Karthik Sarmah, medical student alternate delegate in the California delegation, cited interoperability as a major concern.
"The lack of interoperability is the primary driver of why so many people in this room hate their EHR system," he said, adding that interoperability standards exist, but that there are no incentives for venders to create ways to allow physicians to share their patient data with each other.
Dr. Melissa Garretson, a delegate from the American Academy of Pediatrics, agreed.
"I can’t tell you the number of times I have to repeat labs," and CT scans because data can’t be accessed from other physicians, Dr. Garretson said. She called the lack of interoperability an unfunded mandate on physicians because the vendors aren’t making it possible. "If we force them to do this through legislation, it will finally happen."
Other delegates were skeptical.
"I have been waiting now for about 12 years for this interoperability to occur and I think I’ll either be retired or dead before it finally does," said Dr. Arthur E. Palamara, a vascular surgeon with the Florida delegation.
The House approved a resolution "seeking legislation or regulation to require all EHR vendors to use standard and interoperable software technology to enable cost-efficient use of electronic health records across all health care delivery systems, including institutional and community-based settings of care delivery."
On Twitter @aliciaault