Hospitals Scrambling to Qualify for EHR Incentives, Study Says

PricewaterhouseCooper survey reveals only 50% of hospital CIOs expect to meet “meaningful use” bar for EHR use to qualify for millions in incentive funds when available in 2011.

Health care facilities planning to take advantage of millions in incentives offered under the American Reinvestment and Recovery Act of 2009 (ARRA) for adoption of electronic health records (EHR) technology may not qualify when the funds first become available in 2011, according to a new study by PricewaterhouseCoopers LLP.

The survey of 120 hospital chief information officers (CIO) conducted by PwC’s Health Research Institute (HRI), a research arm of the consulting services giant focused on health reform and business issues, revealed that only half are expecting to qualify for incentive bonuses when the payouts first become available in 2011.

PwC said that the “promise of stimulus funding has accelerated EHR adoption and the collection of massive amounts of electronic health data as hospitals and physicians across the country race to meet eligibility requirements.”

Beginning in 2011, both Medicare and Medicaid will grant millions in financial incentives to health care facilities that meet “meaningful use” criteria for certified EHR, according to Office of Information Technology (OIT) documents.

The funds will come from some $17.2 billion set aside for EHR adoption under the $19.2 billion Health Information Technology for Economic and Clinical Health Care (HITECH) Act.

The money is intended, in part, to offset costs associated with implementing EHR and meeting meaningful use standards.

In January, iHealthBeat, a website reporting on technology’s impact on health care, posted that the Congressional Budget Office (CBO) said that federal incentive payouts for EHR could reach $34 billion. A more recent estimate pegged the bonus amount in a range from $14 billion to $27 billion, according to a report on the site.

Meaningful use, certified EHR spark confusion

Terms of the Recovery Act require health care providers to show that they are using “certified” EHR in a “meaningful” way to qualify for financial incentives. Certified refers to ensuring that the EHR is equipped with the correct features and, generally speaking, meaningful use demonstrates how the features are being used.

About 80 percent of CIOs in the study expressed concern about not meeting the so-called “meaningful use” standard required to land the incentive money by the federally set qualification deadline in 2015.

The PwC study reported that CIOs believe that the “existing infrastructure to support meaningful use of EHRs on a national health information superhighway is insufficient.”

PwC said that CIOs in the study also reported concern over meeting later-stage requirements--such as providing and populating patients’ personal health records and improving data sharing outside their own organizations with insurers, patients and other providers--within the designated time periods.

Requirements will be phased in three separate stages, beginning in 2011 and re-published in 2013 and 2015. The first stage focuses on data capture and sharing, a second phase on advanced clinical processes, and a third on improved outcomes, according to OIT documents.

Daniel Garrett, PwC leader, health information technology practice, said that the survey suggested that some health care providers may be eye-balling “meaningful use” rules too closely rather than constructing long term goals for EHR.

“Healthcare organizations are building high-performance race cars to travel back country roads,” said Garrett. “The bottom line is improved quality of care and patient safety, delivered more efficiently,” he said.

“Government leaders and health organizations need to give consideration to the ultimate goal as they work to finalize and meet guidelines for meaningful use.”

Standards still need clarification, collaboration critical to success

That hospitals appear to be struggling to meet certain criteria for incentive funds is important to solution providers and value added resellers for the opportunity to present those organizations with EHR technology solutions and services.

Indeed, according to the PwC report, hospitals lag in meeting meaningful use standards for a variety of reasons, including lack of clarity on the criteria, shortages of skilled health IT workers, unpreparedness of external vendors and lack of networking capabilities and bandwidth to handle massive data flow associated with EHR implementation.

In the PwC study, 94 percent of CIOs expressed doubt over how to report meaningful use and 92 percent said that they are uncertain of the criteria.

PwC said that its data showed that the big picture view of meaningful use may be getting lost in the scramble for funds.

“Nowhere would the meaningful use of EHRs be more valuable than in a hospital emergency department, where it could mean life or death for a patient,” said Garrett.

“Emergency department physicians aren’t eligible for stimulus incentives but their meaningful use of EHRs is crucial to the hospital and its patients,” he said.

“Hospitals that do not see the path to meaningful use of EHRs as part of a bigger transformational opportunity to improve healthcare quality could be on a long path toward meaningless use.”

Study supports importance of collaboration among physicians, patients, insurers

PwC said that the study revealed that collaboration among physicians and other clinicians is vital to establishing EHR meaningful use. Data indicated that health systems in which physicians, patients and health insurers connect and collaborate around meaningful use are more likely to be ready to apply in 2011 for incentives.

Survey results showed that those organizations are three times more likely to use patient input, 87 percent more likely to work with health insurers and 63 percent more likely to assist physicians with regard to meaningful use planning than applicants who first apply for incentives after 2011.

“Success in achieving meaningful use standards hinges on closer integration with key constituents, physicians, health insurers and patients,” said Kelly Barnes, PwC U.S. leader, health industries.

“Meaningful use of EHRs is an ambitious goal that requires significant clinical, operational and cultural changes, and patients need to be at the center of all planning,” Barnes said.

Participants in the PwC survey belong to the College of Healthcare Information Management Executives (CHIME), an Ann Arbor, MI-based advocacy group of 1,400 CIOs and 70 health care IT vendors and professional services organizations promoting the use of information management to improve health care.

PwC recorded the study’s results in a report entitled “Ready or not: On the road to the meaningful use of EHRs and health IT.”

TAGS: health care,ARRA,EHR,PricewaterhouseCoopers,Medicare

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