AOA opposes ICD-10, supports EHR interoperability, telemedicine

The 10th revision of the International Classification of Diseases and Related Health Problems (ICD-10), practice ownership, increased electronic health record (EHR) system interoperability, and telemedicine were among the subjects on the minds of American Osteopathic Association members July 20 to 22 as they gathered for an annual business meeting in Chicago, Illinois.

The group’s House of Delegates acted on the following resolutions:

• ICD-10. By a 51% majority, the delegates voted to oppose full implementation of ICD-10 despite a recommendation from one of its committees to delay doing so because the final rule set has not been released. Improvements in cost-effective patient care that would result from the updates to the coding system have not been proven to outweigh the anticipated burden to physicians, other healthcare providers, or patients, according to the resolution. The AOA's Department of Government Relations in Washington, DC, will continue to work with the Centers for Medicare and Medicaid Services on this issue.

• EHR interoperability. The group passed a resolution about EHR interoperability that calls for the “development, acceptance, and implementation of an operational, universal, national protected health information technology infrastructure” that will allow healthcare information to be accessed by EHR systems across the country via a universal exchange language or interchange portal. “Interoperability is the key to success for widespread use of [EHRs],” says Emily K. Hurst, DO, an internist in Pontiac, Michigan, and a delegate to the AOA’s House of Delegates representing the Michigan Osteopathic Association, the group that proposed the universal exchange language policy. “[EHRs] have the potential to improve care for our patients, but without these systems being able to talk effectively to each other, physicians aren’t able to use them to their full potential.”

• Telemedicine. Delegates approved a resolution supporting telemedicine and online technologies used for patient care and calling for all payers to adopt systems that reimburse physicians when they provide such services. The group also contends that, within a broad national framework of recommendations, state governments should be granted flexibility in developing and enforcing policies and laws related to licensure, data protection, and patient privacy in ways that meets the health needs of their populations. “Online medicine policies directly tie into the Patient-Centered Medical Home…model for care,” reads the policy statement. “We must simultaneously implement advancements in telemedicine in order to be successful in that new model.”

• The delegates returned for clarification another telemedicine-related resolution, which would have called for the integration of telemedicine into the group’s “mainstream activities of patient care, research, and education.” It also would have directed the AOA to help state societies work with state regulatory agencies to establish guidelines for use of the Internet and other telemedicine programs.

• Payer-owned practices. The delegates withdrew from consideration a resolution that opposed the purchase of medical practices by insurance companies. It had called for the AOA to lobby against any law or policy that favored such arrangements.

Also at the meeting, Ray E. Stowers, DO, a family physician from Harrogate, Tennessee, was sworn in as the 116th president of the organization. He is vice president for health sciences and founding dean of the Lincoln Memorial University–DeBusk College of Osteopathic Medicine. As AOA president, he succeeds Martin S. Levine, DO, a family physician in Bayonne, New Jersey, who is associate dean for educational development at the Touro College of Osteopathic Medicine in New York City.

President-elect of the organization is Norman E. Vinn, DO, a family physician from San Clemente, California. Featured in 2011 in Medical Economics, Vinn is the founder and chief medical officer of Housecall Doctors Medical Group Inc., a network that provides on-site clinical services to high-risk homebound elderly patients in Orange County, California. He also is president of The Residentialists Group Inc., of Laguna Hills, California, a management group specializing in the development and operation of housecall programs.

Earlier in the week, Joseph M. Yasso Jr., DO, an AOA trustee and family physician in Lee’s Summit, Missouri, testified before the House of Representatives Small Business Subcommittee on Investigations, Oversight, and Regulations at a hearing about the effect of healthcare regulations on small and solo medical practices.

“While physicians in all practice settings face financial and administrative burdens, the impact on small practices is particularly disproportionate, detracting from the time available for patient care," Yasso told committee members. Increasingly, family doctors are becoming employees, he noted, but “physicians should not be forced to enter an employed situation out of pure necessity; they should retain their option to choose their ideal practice type absent undue financial considerations and regulatory burdens.”

Doctors must be given payment and incentives if they are to practice effectively in the setting of their choice, he said.

Editor's note: The resolutions linked to in this article are in their initial format and do not reflect any amendments or editorial changes that the delegates approved before passage.

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