POSITION STATEMENTS
117.000 HEALTH INFORMATION TECHNOLOGY
117.000 HEALTH INFORMATION TECHNOLOGY
117.954 Accelerate Integration OF New York State iStop Data into the Multi-State NACP/Bambo Health PMP Program for Opioid Monitoring
The Medical Society of the State of New York (MSSNY) will advocate through legislation and/or regulation for the immediate integration of controlled substance prescribing data from the New York State iSTOP program into the NACP/Bamboo Health PMP for enhanced opioid monitoring through currently utilized EHR solutions. (HOD 2024 – 162)
117.955 Telehealth Payment Parity
The Medical Society of the State of New York (MSSNY) will continue to work with the AMA to advocate for making telehealth payment permanent for Medicare and for all health insurance providers. (HOD 2024 – Adopted in lieu of 100 and 101)
117.956 Appropriate Compensation for Non-Visit Care (Remote or Care of Coordination)
MSSNY will create a policy stating that payors should compensate physicians for asynchronous (outside the day of a patient visit) non-visit or remote care, such phone calls, electronic messaging, and review of laboratory data.
MSSNY will advocate for expansion of CPT codes 99441-99445 into telemedicine parity law, that will include reimbursement similar to other CPT codes.
MSSNY will bring a resolution to the AMA, stating that payors should compensate physicians for asynchronous (outside the day of a patient visit) non-visit or remote care, such as phone calls, electronic messaging, and review of laboratory data. (HOD 2023-262)
117.957 Support of Legalized Interstate Telemedical Care
The MSSNY Council will study the professional consequences of providing telehealth services across state lines including medical malpractice insurance, disciplinary issues, physician licensing, prescribing rights, among others as determined by Council. (HOD 2023-100)
(See Managed Care, 165.000; Medicare, 195.000)
117.958 Opt-Out of Online Physician Rating Websites
MSSNY will continue to investigate and advocate for opportunities such as an opt-out provision to protect physician reputations against inaccurate online commentary. (HOD 2022-62)
117.959 Assisted Living Residence (ALR) NYS Regulation Database
With the support of the NY Medical Directors Association (NYMDA), MSSNY will collaborate with the New York State Department of Health to create an easily accessible database which would make all Assisted Living Residence rules, regulations (ALR) and links to Dear Admin Letters (DALs) available to staff at assisted living facilities, primary care provider teams, hospitals, and/or health systems and which would be updated at least annually. (HOD 2022-103)
117.959 Assisted Living Residence (ALR) NYS Regulation Database
With the support of the NY Medical Directors Association (NYMDA), MSSNY will collaborate with the New York State Department of Health to create an easily accessible database which would make all Assisted Living Residence rules, regulations (ALR) and links to Dear Admin Letters (DALs) available to staff at assisted living facilities, primary care provider teams, hospitals, and/or health systems and which would be updated at least annually. (HOD 2022-103)
117.960 Reciprocal Telehealth Coverage
The MSSNY will advocate for opportunities to enable reciprocal telehealth arrangements with other states so that New York State physicians can continue to provide care via telehealth across state borders, when appropriate, for existing patients. (HOD 2021-105, referred to Council, adopted 3/9/22)
117.961 Telehealth Services
The Medical Society of the State of New York will support legislation that will protect telehealth benefits by CMS and all private health insurance plans, including ERISA plans, after the end of the pandemic and request that AMA assist in these efforts. (HOD 2021-100)
117.962 Separation of Clinical Portions of EHRs from Administrative and Financial Uses
The Medical Society of the State of New York will continue to work with the AMA and specialty societies to advocate for legislation, regulation or other appropriate mechanisms which would ensure that electronic health record (EHR) systems are developed and implemented in such a way as to facilitate the compiling and sharing of clinical information, as appropriate, in a manner that is consistent with how physicians regularly deliver care. (HOD 2020-53; referred to and adopted by Council 3/1/21)
117.963 E-Prescribing Should be Two-Way
The Medical Society of the State of New York will take steps, including legislation or regulation, if necessary, to ensure that pharmacies respond to physician e-prescriptions through the same mechanism by which the physician submitted the e-prescription. (HOD 2020-52)
117.964 Establishing a New York State-Wide Registry for E-Prescriptions
The Medical Society of the State of New York will continue to support the establishment and use of a statewide health information system including patient prescription information that physician can access without undue burden when necessary for patient care. (HOD 2020-50)
117.965 Cloud for E-Prescribing
The Medical Society of the State of New York will work with software vendors and the appropriate regulatory agencies to establish an alternative process allowing for prescriptions to be submitted to a “cloud” where any pharmacy can retrieve and fulfill the prescription. If a patient must change pharmacies due to insurance restrictions, the original pharmacy must submit any remaining refills to the central repository or “cloud” so that the new pharmacy that is in network can retrieve and fulfill the remaining prescription. (HOD 2020-51)
117.966 Home Care Discharge Summary Standardization
MSSNY will work to introduce legislation to require standardization of the Home Health Care Agencies (HHCA) electronic discharge summary as guided by MSSNY member physicians who will be receiving this information. (HOD 2019-106)
117.967 Online Review
MSSNY will work with outside Counsel to develop methods which will effectively and legally ensure the accuracy of online posts and reviews, allowing physicians to respond and review veracity while working within the constraints of the 1st Amendment of the US Constitution. (HOD 2019-101; Reaffirmed HOD 2020)
117.968 All Dispensers Report to the Prescription Monitoring Program
The Medical Society of the State of New York will continue to work with the American Medical Association to update federal regulations which enable physicians to review medication information currently not required to be reported to New York’s I-STOP database, such as medications dispensed as part of opioid treatment programs and the Veterans Administration. (HOD 2019-51)
117.969 Universal Medication Reconciliation
The Medical Society of the State of New York will continue to work with the New York e-Health Collaborative (NYeC) and the State Health Information Network (SHIN-NY) to help ensure that patient medication information is accurately collected and distributed through the Regional Health Information Organizations (RHIOs) in a timely manner and presented in a user friendly format. (HOD 2019-50; Reaffirmed HOD 2020-50)
117.970 Cancelling Prescriptions through EHRs
The Medical Society of the State of New York will advocate that all pharmacies, prescription programs, and vendors of Electronic Health Records (EHRs) adopt technologies which allow physicians to easily cancel medications electronically. (HOD 2018-64)
117.971 MSSNY Supports Health Information Exchange
The Medical Society of the State of New York reaffirms its support for the use of Health Information Exchange services by member physicians and their associated organizations and encourages physicians to contribute patient data to their local Health Information Exchange as long as policies exist that ensure that patient data is adequately secured. MSSNY will continue to work with the New York eHealth Collaborative (NYeC) and the New York State Department of Health (DOH) to better ensure the usability of data and protect physicians from bearing the cost of contributing data to Health Information Exchanges. (HOD 2018-62; Reaffirmed HOD 2020-50)
117.972 Integrating Data into Physician’s E-prescribing Workflow
The Medical Society of the State of New York supports legislative or regulatory efforts to ensure the interoperability of the State’s Prescription Drug Monitoring Registry with electronic health record and e-prescribing workflow. (HOD 2018-167; Reaffirmed HOD 2019 in lieu of res 52)
117.973 EHR Data Access and Data Migration
The Medical Society of the State of New York will work with the AMA to pursue regulations which would:
- require EHR vendors to provide data to the next EHR vendor in a timely and meaningful way and at reasonable cost when requested to do so by the users;
- ensure that vendors provide access to legacy charts on a server for the legal statutory requirement of the specialty and the State for the longest required time and additionally certify and attest to its accuracy and completeness;
- ensure that all upgrades and updates to an electronic health record provide the records in the format of the previous version;
- ensure that vendors are held responsible if litigation results from imperfections or errors caused by their product. (HOD 2017-53)
117.974 Improving HR Technology to Enhance and Track Clinical Outcomes
The Medical Society of the State of New York will advocate that electronic health record companies ensure that their products provide physicians with real time clinical feedback and focus on episodes of care. (HOD 2017-52)
117.975 Recommendations of White Paper: Improve EHR Satisfaction
MSSNY adopts the following recommendations to improve implementation and satisfaction among users of Electronic Health Records (EHR)
- Improve design and workflow so that EHR:
a. doesn’t take away time spent with patients
b. does not interfere with doctor-patient relationship and
c. reduces total time spent on EHR per patient
- Workflow should be customizable not only to fulfill various needs of different specialties, but to accommodate needs of every individual physician as well.
- Reduce documentation that serves functions other than care of patients, and reconsider incentives and penalties.
- Reduce cost of EHR
- EHR should help generate necessary billing reports and allow e-prescription of medications
- EHR should prompt physicians about gaps in care of their patients and also help with clinical decision support.
- Improve interoperability between physicians and all healthcare providers. Peer to peer exchange should be the goal whether it’s direct or through an exchange.
- Improve value of notes in telling the patient’s story and the thought process of the physician rather than the volume of data.
- EHR should capture episodes of care rather than encounters. (Adopted, Council April 17, 2016; Full white paper available upon request; Reaffirmed HOD in lieu of 2017-52)
117.976 Electronic Health Records, a Failure of Health Care Reform
The Medical Society of the State of New York (MSSNY) will urge the American Medical Association (AMA) to research the failure of Electronic Health Records (EHRs) to achieve their stated goals and to ascertain the validity, value and accuracy of various EHRs. MSSNY and the AMA should urge payers to issue a moratorium on penalties for those that do not utilize EHRs since they have not evolved adequately.
It shall be the policy of MSSNY that public and private insurers should not require the use of electronic medical records. (HOD 2016-111)
117.977 Quality Improvement in Clinical/Population Health Information Systems
The Medical Society of the State of New York will request that the American Medical Association invite other expert physician associations into the AMA consortium to further the quality improvement of electronic health records (EHR’s) and Population Health as discussed in the consortium letter of January 21, 2015 to the National Coordinator of Health Information Technology.
MSSNY will support efforts by the AMA to secure specific changes to the EHR certification process which will enhance security of information contained in an EHR, prioritize functionality testing, decouple EHR certification from the meaningful use program and support greater standardization and greater transparency of standards which support interoperability of EHR’s. (HOD 2015-105)
117.978 Meaningful Use Requirements
The Medical Society of the State of New York will work with the American Medical Association to ensure that the Centers for Medicare & Medicaid Services and the National Coordinator for Health Information Technology: (1) adopt a more flexible approach for meeting Meaningful Use; (2) expand hardship exemptions for all meaningful use stages; (3) improve quality reporting; and (4) address physician electronic health record usability and interoperability. (HOD 2015-104)
117.979 Scheduled Medications
MSSNY will work with New York State to improve the I-STOP program by including a link to patient prescription histories which will appear at the time of prescribing as well as at the pharmacy where said prescription is filled. (HOD 2015-101; Reaffirmed HOD 2016-112 & 113)
117.980 Shared Savings and I-STOP
The Medical Society of the State of New York will urge the New York State Department of Health and Department of Financial Services to require health insurers to identify cost savings they have experienced as a result of compliance with the I-STOP law, and that the savings accrued through the use of the I-STOP law be directed toward the development and distribution of electronic medical records (EMR) and electronic prescribing resources which are to be made available to active MSSNY members for use in electronic prescribing and the development of a secure central prescription registry. (HOD 2015-59)
117.981 Patient Consent for Uploading Patient Records to the SHINY-NY And RHIOs
The Medical Society of the State of New York (MSSNY) will seek legislation or regulation that requires patient consent for uploading patient records to Regional Health Information Organizations (RHIOs) and the Statewide Health Information Network of New York (SHINY-NY).
The MSSNY will seek legislation or regulation to tighten access to patient records so as to restrict access without patient consent, ie “break the glass,” only when the patient is not in a conscious or rational state of mind or their legal representative is unable to provide consent and the healthcare provider documents the life-threatening reason for having to access the patient record.
MSSNY will seek to educate patients and patient advocacy organizations concerning the data contained within the SHIN-NY database. (Amended and adopted Council 11/20/2014; from HOD 2014-105; Reaffirmed HOD 2024)
117.982 Exemption Criteria for Electronic Health Record Adoption and Cloud-Based Electronic Health Record Packages
The Medical Society of the State of New York will ask that the American Medical Association (AMA) not give up the fight for Electronic Health Records (EHR) exemptions and continue to petition the Centers for Medicare and Medicaid Services (CMS) to:
(a) Grant solo physician practices and physicians nearing the age of retirement an exemption from the disincentives associated with not using Electronic Health Records (EHR); and
(b) Provide government EHR adoption subsidies for any small and/or solo physician practices that demonstrate a need for these subsidies, beyond the present incentive payment structure; and
(c) Provide cheaper alternatives to commercial EHR systems, either through a lowest-bid Request for Proposal (RFP) process with commercial vendors, or the development of a low-cost or free, CMS-based and administered, cloud-based system for physicians in solo practice and physicians nearing the age of retirement.
The Medical Society of the State of New York will urge the American Medical Association (AMA) request the Centers for Medicare and Medicaid Services (CMS) grant a “temporary waiver” for physician practices that are, in good faith, in the process of obtaining and attempting to implement meaningful use of an Electronic Health Records system, but due to technical issues beyond their control will be unable to meet the October, 2014 attestation deadline. (HOD 2014-107; Reaffirmed HOD 2024)
117.983: Quality of Care, Not Cost, Must be the Criterion Used in Online Patient Searches for Physicians
MSSNY should seek legislation requiring health plans in New York State that offer online physician rankings to include, as part of their rankings, quality criteria such as following quality of care guidelines and evidence-based protocols, as well as treatment outcome and patient satisfaction criteria, as well as legislation prohibiting health plans in New York State from limiting patient searches for physicians by specialty solely to those physicians who meet the plan’s cost criteria. (HOD 2013-267; Reaffirmed HOD 2023; Reaffirmed HOD 2024)
117.984: Electronic Health Record Problems
MSSNY will work with New York’s congressional delegation, as well as encourage the AMA to work proactively with MSSNY, to assure that additional federal financial incentives are provided to encourage physicians to adopt HER, and to assure that physicians who use cloud based electronic health record systems are indemnified for security breaches caused by defects in such systems. (HOD 2013-105; Reaffirmed HOD 2023; Reaffirmed HOD 2024)
117.985: EHR Standardization
MSSNY will seek legislation or regulation to require all EHR vendors in New York State to utilize standard and interoperable software technology components to enable cost efficient use of electronic health records across all health care delivery systems, including institutional and community based settings of care delivery, and will transmit a copy of this resolution to the AMA for consideration at its next House of Delegates meeting. (HOD 2013-104; Reaffirmed HOD 2016-112 & 114; Reaffirmed in lieu of 2017-52)
117.986 AMA – My Medications APP : SUNSET HOD 2022
117.987 Internet Ranking/Rating of Physicians
The Medical Society of the State of New York will:
(1)work with appropriate entities to encourage the adoption of guidelines and standards consistent with AMA policy governing the public release and accurate use of physician data;
(2) continue pursuing initiatives to identify and offer tools to physicians that allow them to manage their online profile and presence;
(3) seek legislation that supports the creation of laws to better protect physicians from cyber-libel, cyber-slander, cyber-bullying and the dissemination of Internet misinformation and provides for civil remedies and criminal sanctions for the violation of such laws; and
(4) work to secure legislation that would require that the Web sites purporting to offer evaluations of physicians state prominently on their Web sites whether or not they are officially endorsed, approved or sanctioned by any medical regulatory agency or authority or organized medical association including a state medical licensing agency, state Department of Health or Medical Board, and whether or not they are a for-profit independent business and have or have not substantiated the authenticity of individuals completing their surveys. (HOD 2012-257; Reaffirmed HOD 2022-62)
117.988 Role of Organized Medicine in Cyberspace Evaluations of Physicians: SUNSET HOD 2020
117.989 Anonymous Cyberspace Evaluations of Physicians:
MSSNY will:
-work with legislators to secure legislation to require that all online sites purporting to evaluate licensed physicians have systems in place to substantiate the authenticity of the persons completing their online surveys to be sure that the persons completing the evaluations are real, bonafide patients and to require that there are controls in place to track and limit the number of responses;
-work with legislators to secure legislation that would make it a crime for a company or an individual that does business or resides in New York State to initiate, facilitate or contribute to on-line slander, libel and misrepresentation of identity or cyberbullying through the internet;
-work with legislators to secure legislation that would require a company or an individual that does business or resides in New York State that maintains a Website which purports to offer evaluations of physicians to register with the Attorney General of the State of New York and to be the subject of routine review for the purpose of determining whether said Website facilitates on-line slander, libel and misrepresentation of identify or cyberbullying;
-work with legislators to secure legislation that would make it a crime for a company or an individual that does business or resides in New York State to violate Internet user agreements.
In addition, MSSNY to bring a resolution on this subject to the American Medical Association. (Council 9/17/09; Reaffirmed HOD 2019)
117.990 AMA Masterfile and AMA Physician Profile: SUNSET HOD 2019
117.991 Waivers – Mutual Privacy Agreements:
MSSNY will examine the use of “mutual privacy agreements” which are utilized by some physicians as a mechanism to prevent patients from posting unfavorable comments on blogs, and recently developed rating websites, as well as other such devices that pre-condition the provision of medical services upon the waiver of individual patient rights. (HOD 2009-212; Reaffirmed HOD 2019)
117.992 Update nydoctorprofile.com:
MSSNY will:
-work with the New York State Department of Health to ensure that the New York State Physician Profile includes the complete name of the training program [i.e. “Program Name” as listed on the Accreditation Council for Graduate Medical Education (ACGME) Website];
-work with the New York State Department of Health to ensure that the New York State Physician Profile stop deleting from the database the name of the medical school or training program that is already listed and verified in the Physician Profile as it corresponds to the name of the institution at the time of the physician’s graduation;
-work with the New York State Department of Health so that the New York State Physician Profile stops automatically overriding correct, accurate information contained in a physician’s profile with inaccurate or incomplete information contained in the AMA Masterfile and AMA Physician Profile;
-pursue efforts to assure that data on public physician profiles contain only correct and appropriate data and that a physician be notified of any changes made by the profiler to allow corrections. (HOD 2009-156; Reaffirmed HOD 2019)
117.993 Information Technology and Stimulus Money: (Sunset HOD 2019)
117.994 Medical Smart Cards:
MSSNY will urge the American Medical Association to study and develop a “white paper” on the issue of medical smart cards and aligned technology, including the role of organized medicine in smart card development, the emergence of regional health information organizations (RHIOs), the opportunity for State and Specialty Societies to obtain grants to educate and inform members of opportunities in this and similar emerging technology and to enumerate the implications which these technologies have for physicians, patients and healthcare, in general. (HOD 2009-92; Reaffirmed HOD 2014; Reaffirmed HOD 2024)
117.995 Fully Functional Universal Health Information Network:
MSSNY will continue working collaboratively with all appropriately recognized entities on the state and federal levels and other healthcare stakeholders to ensure that the standards developed to make health information technology operational in communities across New York State will, in an affordable and user friendly manner, improve efficiency and accuracy in the delivery of healthcare. (HOD 2009-91; Reaffirmed HOD 2010-100; Reaffirmed HOD 2020)
117.996 EHR Interfaces:
MSSNY will encourage the State of New York to (1) require electronic medical records sold in the state of New York to include, at no extra charge, interfaces that communicate with state-wide databases and local Region Health Information Organizations (RHIOs); and (2) set clear standards for electronic interfaces. (HOD 2009-90; Reaffirmed HOD 2019)
117.997 Medical Smart Cards:
MSSNY will:
- educate its members through News of New York, the MSSNY website and other appropriate means of communication, regarding the benefits, technology and availability of medical smart cards, and keep members informed of developments and opportunities in this emerging technology.
- communicate with health care organizations and health insurance plans throughout New York State to urge the development and use of medical smart cards for the purposes of:
- making patients’ information readily available;
- simplifying the task of eligibility verification in physician offices, and
- enhancing and ensuring HIPAA compliance with conversion of paper-based health care information to electronic systems that guarantee the privacy and security of patient information gathered as part of providing health care.
- work with health care insurers and agencies to ensure that physicians do not incur any added expenses to incorporate the use of a health insurer’s / agency’s generated medical smart card into their practice. In addition MSSNY urge those entities, including vendors, which currently charge physicians a fee for smart card readers to provide these free or at a steep discount for MSSNY members.
- develop a collaborative working relationship with the HANYS’ newly created Office of Health Information Technology Transformation, which is studying the development of sustainable health information exchanges on community, regional, and state levels (Regional Health information Organizations or RHIOs). In addition, MSSNY will strive to become an active participant in the GNYHA newly created New York Clinical Information Exchange (NYCLIX) whose goal is to “increase patient safety and the efficiency of care by creating a virtual network for sharing of patient data among health care entities for the purpose of treatment.” NYCLIX is now embarking on the planning phase in order to create implementation of patient data sharing. Both of these initiatives (HANYS and GNYHA) are unique opportunities for MSSNY to provide physician input and expertise at the early stages of these projects.
- prepare a resolution to be forwarded to the AMA House of Delegates to study and develop a “white paper” on the issue of medical smart cards, including the role of organized medicine and specific implications for physicians, patients and healthcare, in general. (Council 1/25/09; Reaffirmed HOD 2019)
117.998 Information Technology:
MSSNY will encourage insurance companies to develop economic incentives, including increased reimbursement rates, for physicians and hospitals that use information technology in the care of their patients. (HOD 2006-92; Reaffirmed HOD 2016; Reaffirmed HOD 2019 in lieu of res 105)
117.999 Putting Economics in Health Information Technology:
MSSNY will continue to work jointly, with the American Medical Association and other organizations, to develop standards and protocols towards affordable and user friendly health information and payment systems. (HOD 2006-81; Reaffirmed HOD 2016)
Position Statements
