Adoption of EHR technology has recently taken criticism from several studies that have called into question everything from their safety to their comprehensiveness to government’s ability to audit their effectiveness.
A study published in this April’s edition of the journal Health Affairs said that many physicians who were planning to attest for Meaningful Use incentive dollars in 2011 did not have EHRs in place that would meet all of the necessary qualifications. Of the 51 percent of doctors surveyed in the study who intended to apply for MU incentives, just 11 percent of all office-based physicians both intended to apply and had EHR systems capable of meeting most of the requirements.
“Our results show that a great discrepancy exists between physicians’ intentions to apply for incentives and their readiness to meet even two-thirds of the core objectives for Meaningful Use,” the researchers from National Center for Health Statistics wrote in their analysis.
Those numbers may be slightly misleading because 43 percent of physicians surveyed that were intending to apply for Meaningful Use were planning on installing a new EHR system within the next 18 months.
Potential adoption rates found by the study are at the low end of projections made by the Centers for Medicare and Medicaid Services in 2010. They estimated that 10–36 percent of Medicare-eligible professionals and 15–47 percent of Medicaid-eligible professionals would demonstrate meaningful use in 2011.
Another study published in April found gaping holes in the processes available in some EHR systems. The study by Los Angeles-based Zynx Health found that 62 percent of hospitals’ EHRs included clinical processes necessary for treating congestive heart failure patients. Pneumonia patients were also left out in the cold with a 67 percent of hospitals’ EHR systems capable of handling their treatment needs.
The brand of EHR did not play a large role in the Zynx survey. Among the five largest EHR vendors in the United States, none of the EHRs averaged better than 73 percent on heart failure or pneumonia functionality. Two vendors had averages below 60 percent.
These studies point to a healthcare industry that is slowly adapting to change with respect to both vendors and users of EHRs. Federal mandates have driven the change and vendors are looking to capitalize on increased demand, but both sides run the risk of leaping before they look.
The government has been paying attention to the shortcomings of providers and vendors, as well as the oversight agency focused on EHR adoption. Last month the Government Accountability Office (GAO) released an audit-based report on improving the EHR-related processes currently in place at the federal Centers for Medicare and Medicaid Services, a section of the Department of Health and Human Services.
In the report, the GAO noted several ways CMS could improve the efficiency and effectiveness of processes to verify whether providers meet program requirements for the Medicare and Medicaid EHR programs. A draft of the report was presented to HHS and CMS for comments.
HHS said CMS will consider conducting more up-front verifications for providers who meet the Medicare EHR program’s reporting requirements and to establish a time frame for evaluating the effectiveness of the CMS’ audits of the EHR systems.
“In addition, HHS believes a more compelling challenge is designing a way for providers to report clinical quality measures electronically from their EHRs to the states and CMS,” the report said. “HHS stated that CMS established pilots that are intended to help providers leverage existing infrastructure to electronically exchange data on clinical quality measures directly from their EHRs to CMS.”