Biggest Health IT Users Have Issues With Meaningful Use

Last Updated Jan 21, 2010 6:01 PM EST

Republicans are not the only ones blocking the Obama Administration's healthcare agenda these days. Hospitals are also pushing back big-time against the "meaningful use" criteria required for them to get government health IT incentives. Healthcare executives are grumbling, in particular, about the large number of quality metrics-35 in all-that they will have to report on in 2011. And three of the largest integrated delivery networks in the country said that they would have difficulty meeting all of the meaningful use requirements.

The latter development must be particularly worrisome to the Department of Health and Human Services, which is responsible for implementing the HITECH provisions of the American Recovery and Reinvestment Act of 2009 (ARRA). When Kaiser Permanente, Catholic Healthcare West, and Intermountain Healthcare all say that some of the meaningful use criteria pose challenges, it is hard to believe that most other hospitals could meet them. Kaiser and Intermountain are particularly advanced in health IT; so if they are having problems, it spells trouble for the entire national initiative to promote adoption of electronic health records.

Other hospital systems are also sounding the alarm on the quality measures. For example, Dallas-based Texas Health Resources has EHRs in 11 of its 13 hospitals and is extensively using computerized physician order entry (CPOE). But it is reporting data to Medicare today on only about a third of the measures that will be required for meaningful use. A Texas Health Resources executive complains that new technology will be needed to supply the new data without burdening staff. It's also pointed out that many physician EHR users now receive lab results in the form of images. Without having a lab interface that can put the data into discrete fields, they won't be able to show meaningful use.

A couple of weeks ago, the American Hospital Association said hospitals should be rewarded for making progress on health IT, not just for meeting specific criteria. CHIME, an organization of health IT executives, pointed out that tight deadlines and quality reporting requirements might make it difficult for many hospitals to show meaningful use in 2011 so they can get the full government incentives.

Even some members of HHS' own Health IT Policy Committee have lashed out at some of the proposed regulations. For example, they want to require physicians to use electronic documentation for patient visits, but that isn't included in the notice of proposed rulemaking.

What all of this points to is the likelihood that the regulations will be significantly revised before they're written into stone sometime this spring. The parallel with the upset of healthcare reform is inescapable. But hopefully, the final regulations on meaningful use will be more effective than the final version of reform is likely to be--if any reforms pass Congress.

And, speaking of reform and related issues, the inimitable Jaan Sidorov has done it again with his "Avatar" themed Health Wonk Review, which rounds up some of the latest and greatest blogs from the Planet Pandora. Visit this world at your own risk, but I can guarantee you won't be sorry.

  • Ken Terry

    Ken Terry, a former senior editor at Medical Economics Magazine, is the author of the book Rx For Health Care Reform.