The U.S. Government Accountability Office (GAO) released a report this week on the meaningful use program, summarizing there was a need for comprehensive strategy to better ensure the reliability of clinical quality measures collected using electronic health records (EHRs).
The GAO’s report looked at meaningful use under the Health Information Technology for Economic and Clinical Health (HITECH) Act, and assessed the extent of current and expected participation in the EHR programs. The agency found that participation in the programs increased substantially from their first year in 2011 to 2012, based on the number of providers awarded incentive payments.
The report looked at the success and challenges of certain meaningful use measures and researchers evaluated HHS efforts to ensure that EHR data can be reliably used to measure quality of care. The result was mixed.
Medicare hospitals reported using computerized provider order entry (CPOE) for over 84 percent of patients, less than 15 percent of professionals reported on an optional Stage 1 measure to provide a summary of care document at each care transition or referral. The lack of a strategy in this regard limits HHS’s ability to reliably clinical quality measures (CQM) collected in certified EHRs for quality measurement activities, the GAO says.
The agency notes that different providers may report CQMs based on and tested to different requirements depending on whether their EHRs have incorporated technical updates.“Without a comprehensive strategy, efforts to address reliability issues (in accordance with the internal control standard requiring relevant and reliable information) and improve quality and efficiency may be limited,” the GAO writes.
The agency recommended not only this kind of strategy, but asked HHS to develop and use outcome-oriented performance measures to monitor progress toward goals. According to the GAO, HHS neither agreed nor disagreed with its recommendations.
GAO also found that hospital participation increased from 45 percent of those eligible for 2011 to 64 percent of those eligible for 2012. . For professionals, such as physicians, participation increased from 21 percent of those eligible for 2011 to 48 percent of those eligible for 2012. However, it did find that a number of providers that participated in 2011 did not participate in 2012.