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Hospitals Could Face Penalties for Missing EHR Deadline

Centers struggle with ‘meaningful use’ goals, study finds

Many U.S. hospitals struggled to meet a federally mandated electronic health record (EHR) deadline, and as a result could collectively face millions of dollars in reduced Medicare payments this year, a University of Michigan study shows.

More than half of hospitals in the U.S. were on the hook to meet a new set of “meaningful use” criteria — known as the stage-2 criteria — by the end of the fiscal year that ended in July 2014. The new study’s data, which were gathered in late 2013, suggest that many may have missed that milestone. At the time, only 5.8% of those hospitals were on track to adopt all 16 of the stage-2 meaningful use goals.

Hospitals that bill the Medicare program and didn’t meet the criteria in fiscal year 2014 will be subject to financial penalties in fiscal year 2015.

“There was likely a big scramble before the deadline, but my sense is that it would have been hard for a lot of those hospitals to meet that deadline,” co-lead investigator Dr. Julia Adler-Milstein said.

The criteria, set forth by the Centers for Medicare and Medicaid, include relatively easy items, such as using EHRs to enter orders for medication as well as laboratory and radiology tests, to chart patients’ vital signs, and to record patients’ demographic characteristics. More difficult activities include sharing EHR data with patients online, sharing electronic data with other providers who care for the same patients, and submitting electronic data to vaccine registries.

“The stage-2 criteria ask hospitals to do several new things with their electronic health records, and the areas that are most challenging are those that require engaging patients, public health providers, and other providers to a greater degree — groups that are outside the four walls of the hospital,” Adler-Milstein said.

The criteria are the second tier of compliance with the 2009 Health Information Technology for Economic and Clinical Health Act (HITECH), which requires hospitals to move from paper to electronic recordkeeping. At first, only a basic set of criteria are required, but once a hospital starts down the path, it must meet higher benchmarks at scheduled dates. The more than half of hospitals that were scheduled to meet the stage-2 meaningful use criteria in 2014 were the first wave to begin adopting digital medical records.

The new study determined that the number of hospitals adopting EHRs continues to rise steeply. Nearly 60% of hospitals now have at least a basic system, and 90% of those centers were on track to achieve many of the 16 core criteria.

The study suggests that, where hospitals are unable to meet stage-2 criteria, they aren’t always to blame. Vendors must upgrade their products to make necessary functions available to meet the criteria, the authors say. These challenges, however, appear to be concentrated in specific types of hospitals.

“Policymakers may want to consider new targeted strategies to ensure that all hospitals move toward meaningful use of electronic health records,” Adler-Milstein said. “We found that rural and small hospitals lag behind, suggesting a need to expand federal efforts to help these institutions select, purchase, implement, and successfully use electronic health records in ways that earn them incentive payments and enable them to engage in new care-delivery and payment models.”

Source: Medical Xpress; August 7, 2014.

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