Health IT Incentives Out Of Reach?

Health information technology advocates say new federal requirements for hospitals to become eligible to receive electronic health record incentives set the bar too high.

Many hospitals are only about half-way toward meeting the criteria for acceptable use of health IT to qualify for federal incentive payments by 2011, according to a new survey from CSC, a technology vendor that sells health IT systems.

"Many hospitals report they have the required capabilities but they are not in active use," state the findings that were released this week. "Readiness is highest in the areas of privacy and security protection."

Meanwhile, some physicians who have analyzed most of the 556-page proposal say the timeframe for the government's goals is probably unrealistic.

On the penultimate day of 2009, the Health and Human Services Department issued preliminary guidelines dictating what hospitals and medical professionals must do by 2011 to receive part of the nearly $20 billion in stimulus funding allocated to encourage the use of e-health records.

This fall, before the official guidelines were out, CSC asked executives at 58 hospitals nationwide to describe their readiness for the basic criteria, including deployment of a certified product, routine use, standards adoption, quality of care reporting and privacy and security protection.

The survey found large holes in hospitals' electronic quality of care reporting and noted that most hospitals do not routinely use e-health records. Health IT is supposed to increase the ease and accuracy of measuring outcomes by allowing hospitals to pull results from records automatically, in real-time and without transcription errors.

A proposed rule announced Dec. 30 defines meaningful use as complying with specific procedures -- including the reliance on certified technologies -- in ways that enhance the coordination of care, engage patients and families, and ensure privacy. A typical 275-bed hospital that makes meaningful use of certified electronic health records, as defined by the department, could be eligible for up to $6 million in bonus payments during the next five years.

The conditions for meaningful use of e-health records will become more specific and stringent during the next few years. The first stage requires providers to electronically capture health information in a coded format to track medical conditions, exchange that data with other professionals to coordinate care and report quality of care statistics. In 2011, participants must report the results of their efforts, including quality of care measurements, to the Centers for Medicare and Medicaid Services.