One of the biggest barriers to meeting the Stage 1 meaningful use criteria for government electronic health record incentives has been the collection of data for clinical quality measures (CQMs). And, to judge by the statements of organizations representing health care providers and EHR vendors, electronic quality reporting and the software rewriting it requires may be even more difficult in Stage 2.
In its comments on the proposed rule for meaningful use Stage 2, the American Hospital Association told CMS that hospitals had encountered “significant difficulty” in using EHRs to do quality reporting in Stage 1. Citing “inaccurate e-specifications” for the electronic measures and “unworkable, but certified, vendor products,” AHA asked CMS not to add any additional measures in Stage 2, but to help providers and vendors “get it right” on quality reporting.
The College of Health Information Management Executives, which represents chief information officers, made similar comments, saying that the CQM data has so far been “inaccurate and largely incomparable across different providers.”
The EHR Association, representing the major vendors, also opposes an increase in the number of CQMs. In its comments, the association expressed concern about the lack of e-specifications in the proposed Stage 2 rule, the absence of provisions for field-testing and the amount of time allotted for vendors to rewrite their software so that it can be used to generate CQM data.
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