Study: Only 6 Percent of Hospitals Meet Electronic Records Requirements
A broad swath of American hospitals have failed to meet new national standards for electronic record keeping, a recent study finds.
While more than half of the hospitals in the U.S. do use some kind of electronic health system, and most meet “many” of the 16 elevated requirements set down by federal regulators, the study said, fewer than 6 percent of meet all the mandates, which span automatic tracking of medications to online messaging systems for communicating with patients.
Hospitals that fail to meet the deadlines may be docked a portion of their Medicare reimbursements.
Small and rural medical centers, often faced with tight staffing and financial restrictions, have been especially burdened by the requirements, which follow a tight time frame that many experts have described as “ambitious.”
“We should be concerned about that group, and in particular think about whether there are more customized policies that are needed to help support them,” says co-lead author Julia Adler-Milstein, an assistant in the School of Information and the School of Public Health at the University of Michigan. “Are there not systems out there to meet their needs? Do they not have access to IT support? We don’t exactly know what the challenges are there.”
Adler-Milstein and her team analyzed the results from 2,674 short-term acute-care general hospitals that participated in an annual American Hospital Association survey. The researchers examined how well hospitals were complying with what’s known as “meaningful use” criteria.
Those criteria stem – indirectly – from the HITECH Act of 2009. The measure appropriated $30 billion to encourage the “meaningful use” of electronic health records by offering incentives through Medicaid and Medicare.
The Centers for Medicare & Medicaid Services, with help from the Office of the National Coordinator for Health Information Technology, then set about creating the benchmarks for what exactly “meaningful use” would be.
“The idea was, ‘What could we do to say what these technologies ought to be able to do, that puts us on a pathway of what we want?’” says David Brailer, who was appointed the country’s first National Coordinator for Health Information Technology in 2004 and currently serves as CEO of Health Evolution Partners, a health care investment firm. “These meaningful-use [goals] were set up to measure some steps toward the real goal.”
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The meaningful use benchmarks were laid out in multiple stages. To meet Stage 1, for example, participating hospitals were essentially required to have basic electronic health systems that met 14 “core objectives,” from recording demographic information to keeping an active list of patients’ medications. To meet the next round, Stage 2, hospitals needed to use those systems more robustly – such as by incorporating online lab test results – and also make sure they complied with updated software standards, which proved more stringent than in Stage 1.
The ramp-up from Stage 1 to Stage 2, in fact, amounted as a whole to “a hugely ambitious goal,” says Dan Paoletti, CEO of the Ohio Health Information Partnership, a nonprofit.
“Think about where we were just three, four, five years ago before the HITECH Act came in,” he tells U.S. News. “I can’t think of a time in history, maybe with the exception of World War II when all the hospitals were built, when health care’s undergone such a dramatic change. We’re really talking about moving everybody into a health information technology adoption, and with that is going to come all kinds of problems.”
CMS and ONC released a notice of proposed rule-making in May, which, if approved, would extend the deadlines to meet Stage 2.
An ONC public health analyst was listed as one of the authors of Thursday’s study. In a statement, the agency highlighted the large numbers of doctors and hospitals who have adopted electronic health records, and also vowed to reach out to those who were lagging behind.
“Patients are seeing the benefits of health IT as a result of the significant strides that have been made in the adoption and meaningful use of electronic health records,” Dr. Karen DeSalvo, national coordinator for health information technology, said in the statement. “We look forward to working with our partners to ensure that people’s digital health information follows them across the care continuum so it will be there when it matters most.”
CMS did not return requests for comment.
“HITECH’s immediate purpose was to build a nationwide IT infrastructure, with the ultimate goal of improving the nation’s health care delivery system and health outcomes,” Adler-Milstein’s study said. “If this goal is to be achieved, ongoing and deliberate efforts are needed.”
The paper, which Adler-Milstein wrote with co-lead author Catherine M. DesRoches, was published Thursday in the journal Health Affairs.