MMS Urges Adoption of Regulations Governing Licensure, Health IT

WALTHAM — The Mass. Medical Society recently urged the state Board of Registration in Medicine (BRM) to adopt a set of proposed regulations that would satisfy a statutory requirement that physicians demonstrate proficiency in health information technology as a condition of maintaining their license to practice medicine.

Testifying before the BRM, society Vice President Dr. James Gessner said the requirement is a provision of Chapter 224, the state health-reform law on cost control and quality enacted in August 2012.

Chapter 224 required the BRM to establish as a condition of licensure regulations that physicians “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.” The law further specified that, to demonstrate such proficiency, physicians must establish the skills to comply with federal meaningful-use requirements for health information technology. The requirement takes effect Jan. 1, 2015.

According to the Massachusetts eHealth Institute, however, only 15,000 physicians who practice in the state have met or are expected to meet federal meaningful-use requirements. The state currently licenses more than 40,000 physicians.

 “Most of the remaining physicians are, under the law, ineligible for meaningful-use incentives and could lose their license if this statute were interpreted to require meaningful use as a standard for licensure,” said Gessner adding that this situation would severely affect patient access to care across the Commonwealth, as physicians are prohibited from practicing medicine without a license.

“The board has been left to interpret this statutory requirement on its own in a logical manner that is productive and serves the interests of the public,” Gessner testified. “The Massachusetts Medical Society strongly supports the proposed regulatory approach the board has taken in compiling a thoughtful way to implement this requirement.”

Among the BRM’s proposals are a provision that applicants may demonstrate skills through their employment with, credentialing by, or contractual agreements with an eligible hospital or critical-access hospital with a federally certified meaningful-use program; by being either a participant or authorized user in the Massachusetts Health Information Highway; or by completing three hours of continuing medical education in electronic records and meaningful use.

The BRM also proposed several exemptions from the requirement, including those not engaged in the practice of medicine, such  as researchers; medical residents and interns who are experienced with electronic records; those holding an administrative license and not engaged in direct patient care; those with a volunteer license, as these physicians often provide care to the most vulnerable and needy patients; and those on active military duty called into service during a national emergency.

Gessner, while indicating that large numbers of physicians will be able to comply with the statutory requirement by participating in one of the proposed categories, also cautioned BRM members that, “should any of these categories be eliminated or substantially changed, the impact would be profound on physicians, patients, and the board itself to process such denials of licensure.”