The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) recently issued two regulations to implement the electronic health record (EHR) incentive programs enacted under the American Recovery Act of 2009. The regulations are a first step toward the improvement of quality, efficiency and safety through meaningful use of certified EHR technology.
In order for professionals and hospitals to be eligible to receive payments under the Medicare and Medicaid EHR incentive programs, they must be able to demonstrate meaningful use of a certified EHR system. As such, CMS’ proposed regulation defines and specifies how to demonstrate “meaningful use” of EHR technology. Specifically, meaningful use is defined as the use of certified EHR technology in a form and manner consistent with certain objectives and measures such as: the improvement of quality, efficiency and safety of health care delivery; reduction of health care disparities; engagement of patients and families; improvement of care coordination; and adequate privacy and security protections for personal health information.
Healthcare providers and executives generally agree that electronic health records hold great promise for improving health care quality, efficiency and safety. It is thus not surprising that quality metrics are central to the meaningful use requirements. However, the number of quality measures included for 2011 was surprising. The interim final rule requires hospitals to report on 35 quality measures as a condition of demonstrating meaningful use. While all of these measures are important, many players in the health care industry have raised concerns. Some state that they currently track only one half to one third of these measures. Another challenge is the maturity of the technology to produce the required reports in a timely manner. While a clinical application that allows real-time reporting on quality measures is necessary, many systems that are currently available are not robust enough to produce the required reports.
Hospitals and physicians alike will face challenges in attempting to meet the quality reporting requirements. Many physicians do not capture clinical data in a discrete format. Some physicians choose to scan in lab reports.
While the IRF is still open for comments at this time, hospitals and physicians will need to review closely the systems they have in place and revise their processes where needed to ensure that they can meet the meaningful use requirement. Quality measures are becoming increasingly important and are no longer affecting just patient care and program integrity but program funding as well.
Posted by: Deborah Hutchison, Manager at Strategic Management
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