Calling many of the quality reporting measures "hidden requirements" of Stage 1 meaningful use of EMRs, consulting firm Computer Sciences Corp. says hospitals that meet the data-capture standards for meaningful use still will only have about 35 percent of the data they need to report on the 15 "core" measures.
"Much attention has been paid to some of the explicit data capture requirements for meaningful use--computerized physician order entry in particular--because so much work lies ahead for most U.S. hospitals to implement these functions. However, we believe that the quality reporting requirements for Stage 1, the first increment of meaningful use to be achieved, will be equally challenging," CSC concludes in a recently published report.
CSC consultants broke down the 15 "core" measures that hospitals are required to report on, to examine the individual data elements and sources of electronic documentation they will need to meet the CMS reporting standards, and found significant issues with "hidden" requirements.
The most daunting challenge, CSC says, is a shortage of physician documentation in the EMR and electronic medication administration systems. Clinical IT systems tend to be lacking in emergency departments, the source of 30 percent of the data elements from physician documentation and 10 percent of data elements related to med administration. EDs were added to the equation for meaningful use in the final rule after being left out of a previous proposal.
"In addition, several measures require information about care during a patient's stay in the surgical suite. Many hospitals use standalone clinical software in these care areas or may lack clinical IT altogether," according to the report.