Hospital CIOs confused over e-health records rollout standards

Lack of clarity about government rules slowing efforts, survey says

The vast majority of hospital CIOs recently surveyed by PricewaterhouseCoopers LLP (PwC) said they're concerned that they won't be able to demonstrate "meaningful use" of electronic health records (EHR) -- and therefore won't qualify for federal reimbursements for rolling out the technology.

Ninety-four percent of the CIOs responding to the survey whose results were released Tuesday said that they're concerned they can't meet government requirements about how to report meaningful use of EHRs, and 92% said that they're concerned about a lack of clarity in the criteria used by the government.

Last year, the American Recovery and Reinvestment Act (ARRA) set aside $36 billion to help hospitals and doctors purchase equipment to computerize patient medical records, but even the most sophisticated hospitals in the country are struggling to qualify for the payments, PwC's study indicated. Clinicians and hospitals that deploy the technology and prove that it meets a set of government "meaningful use" standards showing it's being effectively used can receive up to $44,000 per doctor in reimbursement funds beginning next year.

A 275-bed hospital, for example, would be eligible for about $6 million to defray IT costs.

There is a four-year window to receive the reimbursement funds, and by 2015, facilities that have not deployed EHRs will face Medicare and Medicaid reimbursement cuts. Last year, just 10% of health care facilities in the U.S. used EHRs; by 2014, the government wants more than half of all facilities to use them.

The problem is that in order to finish EHR projects and receive full reimbursements, health care providers must begin working on EHR initiatives now. The U.S. Department of Health and Human Services (DHS) has already published a 556-page draft list of specifications and criteria for what constitutes "meaningful use" of EHRs. The final "meaningful use" rules are slated to be published as early as next week, according to sources.

According to PwC's survey, which was conducted during the second quarter of 2010 and included 120 hospital CIOs, 80% of tech executives are "concerned or very concerned" they will not be able to demonstrate meaningful use by 2015. And only half of the hospital and health system CIOs surveyed said they will be prepared to meet the first set of meaningful use requirements and apply for incentive bonuses in 2011, the first year they are available.

Bruce Henderson, national leader of PwC's Electronic Health Records and Health Information Exchange Practice, said what surprised him about the survey results was the "overwhelming concern" across the industry. "I think that even among the more prepared institutions that have adopted clinical record systems already there's still a fair amount of concern about being able to ... be in compliance with those regulations within the time period in which the first draft stipulated," he said.

The 120 CIOs, all members of the College of Healthcare Information Management Executives (CHIME), are also worried about meeting later-stage requirements within the specified time frames.

The meaningful use standards are expected to require health care providers to do the following: use software to ensure that best practices for medical care are followed, regularly update the information in patients' personal health records, and improve health care outcomes by sharing data with third parties, such as with insurers, patients and other providers.

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