In July, ACEP hosted a HIT Summit. More than 90 technology representatives met with our leadership, staff, and content experts to have a meaningful conversation on how those vendors could assist with better interfaces to remove some barriers to patient care. In addition, after considering how best to attack these issues, I created and appointed the HIT Committee that will meet for the first time here in Denver. You know us – when  emergency physicians see a problem, we build a solution.

About a decade ago, I dabbled with HIT by representing my health systems’s medical staff in introducing an electronic health record and physician order entry. I got a glimpse into the value of a human interface between the clinicians and the technicians.  Many of our own emergency physicians have surpassed me greatly with their enthusiasm and knowledge in this area. As ACEP leaders, we believe the committee structure will give more intention to this tremendous need, help with creating new content, and build relationships with other standing committees that may benefit by this expertise.

No discussion on workplace in the current climate can leave out the paramount issues related to fair payment and fair coverage. I do not intend to go into the depth Dr. [Vidor] Friedman shared in his speech yesterday, but our attention to this issue must not only be maintained but also broaden in scope. Our DC staff, led by [ACEP Associate Director for Public Affairs] Laura Wooster, and our physician advocates, led by Dr. Friedman, have worked incessantly on this issue.  For those in the room or outside of it who are skeptical of the value of ACEP, this issue alone is worth every bit of dues you will pay for many years.

I certainly understand we have a lot to do to get to even a palatable solution, but without their work, this effort would have settled out a long time ago – with an unfavorable outcome to emergency physicians. Your payment rates would have been set with at least a 30 percent drop, and the freefall to the bottom would have continued unabated. This work must continue – not only to ensure current and future generations of physicians choose our specialty, but to make sure our hospitals can continue to provide emergency care for our patients, especially in rural and other underserved communities.

But as a specialty, we cannot only look to others to determine payment. We have also worked through value-based payment systems for years; initially in a very small way, but now in increasing importance. As with many issues, Dr. Gerardi was prescient almost fiveyears ago in creating the Alternative Payment Model Task Force. I have had the pleasure of representing the Board for this effort, which has been led admirably by Drs. Jeff Bettinger and Randy Pilgrim. As you may recall, this risk-based payment model would allow our EDs to look at several common symptom complexes, and with the support of additional funding for care coordination, would allow us to receive additional value-based payments.