Health IT, Policy

CIOs worry if their hospitals are ready for meaningful use

Meaningful use. The phrase applied to using electronic health records (EHRs) in ways that raise […]

Meaningful use.

The phrase applied to using electronic health records (EHRs) in ways that raise the quality of healthcare while reducing its cost is striking anxiety in the hearts of hospital chief information officers nationwide.

Despite the $22 billion in federal incentives soon to be available to hospitals and doctors’ offices that install and use the systems — and the army of organizations ready to help them — only half of the chief information officers (CIOs) at hospitals and health systems surveyed recently by global business consultant PricewaterhouseCoopers expect to meet the first set of requirements to get incentives next year.

“I think we all wonder if we’re going to be ready,” said John McInally, chief information officer for MetroHealth System in Cleveland, Ohio, which as been investing in electronic health systems for more than a decade. “I don’t know any of my colleagues anywhere that feel they’re completely ready for meaningful use.”

The Obama administration is dangling large financial carrots — and eventually will use big financial sticks — to get both hospitals and doctors to adopt the technology aimed at helping to reform the nation’s healthcare system.

And it’s not just the current administration. Federal policymakers decided 10 years ago that most American should have electronic health records by 2014, according to the Centers for Disease Control and Prevention (pdf). That federal deadline has since been pushed to 2015.

Why all the fuss about meaningful use and electronic health records?

“Certified electronic health record technology used in a meaningful way is one piece of a broader health information technology infrastructure needed to … improve healthcare quality, efficiency and patient safety,” according to the Office of the National Coordinator for Health Information Technology.

Some of the CIO uncertainty is coming from lack of clarity. Final meaningful use rules aren’t due out until the end of summer, so a lot of the information officers have question marks in their electronic health record strategies.

“The rules require that you have an electronic health record that has been certified, and there are temporary certification rules,” said McInally, who came to MetroHealth in December after spending several years as chief information officer at Stanford University Medical Center’s Lucille Packard Children’s Hospital. “So there’s a lot of final work that has to happen. And we’re talking about a political process.”

For some information officers, the concern also is a matter of resources. Many small or rural hospitals don’t have the money to buy and use the electronic record systems that will be federally mandated in five years. The PricewaterhouseCoopers survey doesn’t even address doctors’ offices, which may have fewer financial resources. That’s where the federal (and some state) incentives come in.

In Ohio, that means $27 million in federal stimulus and state money for seven regional extension centers like Case Western Reserve University that will help hospitals and doctors adopt electronic health records. The recently created Ohio Health Information Partnership is using $14.9 million in federal funds, with a state match of $2.1 million, to set up a state health information exchange.

The promise of stimulus money has accelerated EHRs adoption and the collection of massive amounts of electronic health data by hospitals and physicians nationwide, PricewaterhouseCoopers said. But the infrastructure to support meaningful use of EHRs in a yet-to-be-created national health information exchange is insufficient, according to CIOs who were  interviewed by the consultant.

Some CIOs are worried about the readiness of companies that sell and implement electronic record systems, PricewaterhouseCoopers said. EHRs and information technology vendors have been jockeying for market position by buying each other lately. That could make for unprepared or unstable vendors.

Others are concerned their institutions have too few skilled staff members to integrate the electronic systems, which have clinical, operational and administrative components, the consultant said.

In the end, it won’t be the systems hospitals install, but how they use those systems that matter.

That’s why some CIOs worry about meeting later meaningful use requirements, such as advancing care processes through decision support, providing and populating patients’ personal health records, and improving health outcomes through data-sharing with insurers, patients and other providers, PricewaterhouseCooper’s Health Research Institute said in its report.

“The real test, though, will be the new quality reporting requirements that come with this meaningful use,” MetroHealth’s McInally said. “So it’s not enough to just have the information systems installed from certified vendors, but you also have to be able to produce reporting that demonstrates you’re using those systems to assure high-quality patient care.”

Shares0
Shares0