AHA case study suggests EHRs aren’t good at automated quality reporting

January 12th, 2015

A four-hospital case study commissioned by the American Hospital Association has found some serious problems with regard to implementation of the Medicare Electronic Health Record Incentive Program’s Meaningful Use Stage 1 electronic clinical quality measures (eCQMs).

Although the report doesn’t name the hospitals, it contends that “[e]ach of the organizations visited was well situated for success in eCQM adoption,” and that “[e]ach was externally recognized by national programs for its level of EHR adoption, with significant efforts preceding the MU program by five to 10 years.”

So they all should have been well-positioned to meet the requirements. But, according to the report, problems abounded in four specific areas:

• Program design – including “unclear specifications” and “unfamiliar vocabularies to define required data.”
• Technology – including the fact that the “[h]ospitals experienced significant difficulty implementing eCQM tools in their EHRs” and that the “EHR could not draw relevant data from other systems.”
• Clinical – including that eCQM implementation added to clinicians’ workloads “with no perceived benefit to patient care.”
• Strategic – most notably that “Hospitals expended excessive effort on the eCQMs that negatively affected other strategic priorities.”

The recommendations the AHA makes at the end of the report aren’t surprising, especially the first one. The organization certainly isn’t alone in wanting to “slow the pace of the transition to electronic quality reporting with fewer but better-tested measures, starting with [Meaningful Use] Stage 2.” So far, though, I haven’t seen too many signs that the powers that be are interested in heeding that advice.