Even some of the more sophisticated electronic health record users are running into trouble using their EHRs to generate the clinical quality measures (CQMs) required by the Meaningful Use program, according to a new American Hospital Association report.
The AHA-commissioned study analyzed the electronic CQM implementation of four hospitals experienced with EHRs. Each hospital was using an EHR from a different vendor.
The report revealed that all four hospitals found it harder to use their EHRs to generate eCQMs than they anticipated, and that the effort raised costs without providing accurate data. Some of the problems included:
- EHRs had to be modified to support data capture and meet eCQM tool requirements
- The eCQM specifications were difficult to access, complex, contained inaccuracies and were not maintained over time
- The eCQM tools from vendors did not work as expected and did not efficiently generate accurate measures
- The eCQMs added to clinicians' workloads and provided no perceived benefit to patient care
The authors recommended that:
- The government slow the pace of requiring eCQMs
- The government use fewer but better tested eCQMs
- The measuring tools be improved
- Users be provided with clear guidance and a consistent process
- The program support accurate measurement
"This study demonstrates that successful implementation of current policy requirements for eCQMs must be redirected so that the EHRs are working for the clinicians rather than the clinicians spending extensive amounts of time working for the EHRs," the report's authors concluded. "Unless eCQMs are more robustly tested before incorporation in widespread national programs such as Meaningful Use, the reality is that hospitals will not be able to meet the new standards and certified EHRs will not deliver on the promise of eCQMs to improve patient care, provide comparative quality information to consumers and reduce the burden of quality reporting."
Provider representatives have long expressed concern with the Meaningful Use program's quality measures, noting that complete, accurate data reporting via EHRs was "nearly impossible," the proposed thresholds were "unrealistic" and the CQM process was "rushed."
To learn more:
- access the report (.pdf)