Meeting the computerized provider order entry requirement is the biggest challenge to hospitals participating in the Meaningful Use incentive program, according to a study published in the Journal of the American Informatics Association.
The researchers, from the University of Florida and elsewhere, analyzed 2,475 hospitals that had indicated their intention to participate in the incentive program. Of these, only 313 (12.6 percent) received an incentive payment in 2011. One-half of the hospitals that didn't make the grade reported that they believed that CPOE criteria will be a primary challenge; hospitals that reported this criterion as a primary challenge were 18 percent less likely to receive a 2011 Meaningful Use payment.
In contrast, the hospitals that achieved Meaningful Use were more likely to report that the anticipated primary challenges would be giving patients access to their data in electronic form and generating numerator and denominator data for quality reporting directly from the EHR.
The study's authors expressed concern that the successful hospitals' primary challenges were technological in nature, but that the hospitals struggling with CPOE were dealing with technological, cultural and organizational barriers. They said that the incentive program may disproportionately reward hospitals that already are using EHRs and had the infrastructure to meet such criteria.
That disparity could increase as the program moves into Stage 2, where the CPOE criteria are even more stringent; the threshold requirement has been doubled from 30 to 60 percent for medications and adding in lab and radiology.
"As the EHR incentive program matures, policymakers and other stakeholders should consider strategies that maintain the critical elements of MU while adequately supporting hospitals that desire to become MU but are impeded by specific technological, cultural, and organizational adoption and use challenges," the authors wrote.