Even with the relaxed Stage I criteria for demonstrating meaningful use of electronic health records, members of the College of Health Information Management Executives are becoming less optimistic that hospitals will be in a position to receive financial incentives for meeting meaningful use measures early in the program.

CHIME first surveyed its members – which include chief information officers and other senior health care IT executives from provider organizations, including large hospital systems, community hospitals, for-profit hospitals, and small or rural facilities – in August after the final rule for demonstrating meaningful use was issued by CMS (Also see "CMS Reduces Criteria To Qualify For Electronic Health Record Financial Incentives In Final Rule" - Pink Sheet, 13 July, 2010.). Its most recent survey took place in November.

What remained consistent through the first two quarterly surveys was the percentage of respondents (89%) that expect their organizations to be able to qualify for stimulus funding during Stage 1 of the program, which extends to Sept. 30, 2012.

What has changed, however, is when the respondents believe meaningful use will be achieved.

“In the most recent survey, 15% of responding CIOs said their organization would qualify for funding within the first six months, compared with 28% who responded to the first CHIME survey,” a report from CHIME noted.

“By contrast, 74% of respondents predicted that they would qualify for funding, but reported they were unlikely to do so until later in the timeframe for Stage I (late in FY 2011 or during FY 2012, which ends on Sept. 30, 2012). That was up from 61% who responded from the first CHIME survey.”

Also consistent between the two surveys was the number of respondents who said they would not receive funding during Stage 1, about 11%. Funding for adoption incentives is provided by the American Recovery and Reinvestment Act. The 2009 stimulus package also details penalties, in the form of reduced Medicare reimbursement, should providers fail to adopt (Also see "Adoption Of E-Health Records Gets Stimulus Of Medicare Rewards, Penalties" - Pink Sheet, 2 March, 2009.).

Survey Lists Main Concerns

CHIME said 82% of respondents reported concerns about aspects of the meaningful use rule that could interfere with collection of ARRA incentives.

Asked to name the top concern that could slow the ability to meet meaningful, most survey respondents identified implementation of computerized physician order entry (29%), followed by the capture and submission of quality measures (22%). Tied at third were IT staffing shortages and certification and implementation issues at 11%.

The respondents were also asked to list their second-most-important concern: 24% said capturing/submitting quality measures and 20% said IT staffing shortages.

“When asked specifically about whether they anticipated challenges implementing CPOE, some 62% of respondents reported they expected difficulties ahead,” the report states. “Nearly 52% of those expecting problems said their biggest challenge would be to get clinicians to enter orders into the CPOE system.”

By Gregory Twachtman

Meeting EHR Meaningful Use Criteria Harder Than Previously Thought – Survey

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