CIOs Seek More Time for Electronic Records

An organization of hospital CIOs and other health IT executives is urging the federal government to give health-care providers more time to prepare for the second stage of electronic health record implementation.

The College of Healthcare Information Management Executives (CHIME) suggests that medical providers be given a 90-day period to demonstrate that their EHRs meet upgraded standards for meaningful use. A similar 90-day period was granted as providers worked to meet the first stage of requirements for usage.

Providers must demonstrate compliance with meaningful-use standards to qualify for Medicare and Medicaid cash incentives.

CHIME sent letters Monday with its recommendations to the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC).

“We felt the approach taken in Stage 1 gave providers much-needed time to make sure the correct fields were populating and accurate meaningful use reports were being produced – we think a similar approach is needed for Stage 2 and beyond,” says Pam McNutt, a member of CHIME’s policy steering committee, in a news release issued by CHIME.

“While we appreciate the delay of Stage 2 to fiscal year 2014, that decision was necessary, given that no one would be in a position to meet Stage 2 requirements beginning Oct. 1, 2012,” said McNutt, senior vice president and chief information officer at Dallas-based Methodist Health System. “By giving providers flexibility through a 90-day reporting window, CMS can ensure that more Stage 1 meaningful users will become Stage 2 meaningful users.”

CHIME suggests that ONC require that EHR products be certified to meet clinical quality measures in different medical settings as part of its base EHR certification. The number of quality measurements associated with each type of setting should be minimized, CHIME says.

“Our experience indicates that [clinical quality management] data produced through EHRs is inconsistent, inaccurate and ultimately a poor indicator of how well certain providers perform. We believe the direction proposed by ONC for CQMs is bold, but necessary, because these same measures increasingly will be used to justify reimbursement and judge provider outcomes,” CHIME wrote in a nine-page letter to Dr. Farzad Mostashari, national coordinator for health IT.

Providers are concerned that EHR certification criteria “provides insufficient mechanisms for providers to pursue the most meaningful uses of their technology.” In the first stage, “some vendors were able to dictate which clinical quality measures providers chose to report – not based on the priorities of the provider, but based on the capabilities of the system.”

The organization argues that “flexibility for users necessitates consistent and robust standards for [EHR] developers. In short, the 2014 Edition [of meaningful use standards] must require more of the vendor community if providers are to have space to pursue meaningful use” of the standards.

CHIME’s 46-page letter to Marilyn Tavenner, acting CMS administrator, provides more detailed explanations of the organization’s concerns and recommendations.