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AMA to set guidelines on control of record data

Clarifying physician ownership of EMR patient data becomes crucial in an era of pay-for-performance programs.

By Kevin B. O’Reilly — Posted Nov. 28, 2005

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Dallas -- According to industry estimates, one in seven full-time physicians has adopted an electronic medical records system, and as the Bush administration pushes hard to increase that figure, doctors want to make sure they have control over how the data are collected and used.

The American Medical Association will develop guidelines on how EMR information and claims data by third parties are collected, warehoused and used after members of the House of Delegates voted in favor of new policies at the Association's Interim Meeting in Dallas earlier this month.

The AMA also will advocate that physicians own the data and will explore the idea of a physician-run EMR repository.

"We generate a tremendous amount of data as physicians," said William A. Hazel Jr., MD, a member of the AMA's Board of Trustees and an orthopedic surgeon from Herndon, Va.

"The operational questions are where the data lives and who has access. There's also the question of who owns the data. Some parts of it, such as patient information, clearly belong to physicians."

Dr. Hazel said this is a concern because "there is tremendous economic value to the cumulative data in terms of analyzing patterns," and without clear physician ownership, third-party vendors could reap the profits. Control of the data is also crucial to the debate over pay-for-performance programs, he said.

According to the Medical Group Management Assn., 14.1% of all physician group practices have an EMR system in place, and close to 20% of practices with 11 or more physicians have gone electronic. CMS has said 13% of solo practices have an EMR.

What has left physicians uneasy is that many of the agreements with third-party vendors who license and administer EMRs leave unclear who owns the data, especially when a relationship ends.

The AMA already has policies on core data content standards, confidentiality, integrity and security of electronic patient information, on-site storage of medical record information and electronic claims transaction requirements.

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