• CHIME Fears Hospitals Unable to Submit Complete, Accurate Quality Data via EHRs

    ANN ARBOR, MI, January 28, 2013 – In comments submitted to the Centers for Medicare and Medicaid Services (CMS) today, the College of Healthcare Information Management Executives (CHIME) voiced concern about hospital readiness to submit accurate and complete quality data by way of electronic health record systems.

    Responding to a Request for Information (RFI) issued by CMS on hospital and vendor readiness to submit electronic quality data as part of the Inpatient Quality Data Reporting (IQR) program, CHIME thanked federal efforts towards reaching a harmonized approach for electronic clinical quality measurement (CQM) and supports efforts to aligning EHR-based reporting and hospital quality reporting programs. But the organization of healthcare CIOs also warned that current technology and workflow burdens make accurate and complete quality data reporting through the EHR nearly impossible.

    “CHIME has long-advocated for HHS to take a lead role in CQM harmonization – extending through (1) the specific CQM, (2) how the CQM is reported, and (3) to whom it is reported,” CHIME said. “While we are encouraged by recent efforts by CMS, AHRQ and others, we worry that workflow and technology implications of complete and accurate electronic quality reporting are not fully understood. Data used by abstractors are often found in dictated reports or free form progress notes, not as structured data in the electronic health record. And it has been the experience of our members that without making the entire record structured, discreet data or having mature text recognition software in place, one cannot extract all the data needed on every patient to create accurate quality metrics.”

    CHIME also commended CMS for establishing a volunteer pilot program for hospitals to submit CQM data electronically as part of the EHR Incentive Payments program, rather than through attestation. CHIME urged CMS to seek ways to broaden the program to more hospitals and use the results obtained by pilot participants to further inform hospital and vendor readiness of EHRs to support IQR.

    Finally, CHIME urged policymakers and regulators to be bold in their work to establish a unified approach to electronic quality measurement, telling CMS that “Over the past several years, HHS has demonstrated an increasing ability to convene public and private sector stakeholders to harmonize disparate health IT system requirements, technical standards and disseminate best practices. Meaningful Use is, perhaps, the best example of such policy approaches. However, CHIME believes that such harmonization with regards to CQMs is overdue – and we believe that the time to leverage such a focus on electronic CQM development and reporting is now.”

    The full text of CHIME’s letter to CMS can be found at chimecentral.org/wp-content/uploads/2014/11/CHIME_Response_to_CMS_IQR_RFI.pdf.

    About CHIME
    The College of Healthcare Information Management Executives (CHIME) is an executive organization dedicated to serving chief information officers and other senior healthcare IT leaders. With more than 1,450 CIO members and over 85 healthcare IT vendors and professional services firms, CHIME provides a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate; exchange best practices; address professional development needs; and advocate the effective use of information management to improve the health and healthcare in the communities they serve. For more information, please visit www.chimecentral.org.

    Contact
    Stephanie Fraser
    Director of Communications
    734.665.0000
    [email protected]

    Updated: 1/28/2013 12:07:02 PM

    Posted 1.28.2013

  • CHIME Cautions Pace, Practicality of Stage 3 Meaningful Use Measures

    ANN ARBOR, MI, January 14, 2013 – In comments submitted to the Health IT Policy Committee and the Office of the National Coordinator for Health IT (ONC) today, the College of Healthcare Information Management Executives (CHIME) called on regulators to reconsider the speed and scale for achieving Stage 3 meaningful use objectives by 2016.

    Responding to a Request for Comment issued by the HIT Policy Committee in late November, CHIME urged the federal advisory committee to recommend thorough evaluations of what has been accomplished thus far in order to place realistic measures and objectives for the nation’s hospitals in Stage 3.

    “We see no value in setting unrealistic performance thresholds or expectations before current evaluations of what we have accomplished have been undertaken,” CHIME said. “[E]very desirable EHR-related objective cannot feasibly be met by 2016, nor do we see any value in attempting the rushed adoption of various EHR uses by that time. Instead, verifiable and continuous progress should be the goal.”

    “One of our main messages to regulators is that we shouldn’t look to cram everything into Stage 3,” said Pam McNutt, Senior Vice President and Chief Information Officer at Dallas-based Methodist Hospital System and member of CHIME’s Policy Steering Committee. “The modernization of America’s healthcare system is a decade-long progression. We need to make sure that the HIT Policy Committee is looking at more than just the Stage 2 measures and objectives when making recommendations to HHS; that’s why we strongly urged thorough evaluations of to-date accomplishments and progress.”

    In response to measures and objectives under consideration for Stage 3 meaningful use, the organization of healthcare CIOs made the following recommendations:

    * Actual and proven HIE operations and interoperability, combined with a standard and highly-reliable way to identify patients, is mandatory to achieve the goals of Stage 3, and even stage 2; Encourage that the time frames for Stage 3 be linked to and preceded by proven HIE capabilities.

    * Ensure that EHR certification requirements yield vendor products that allow EPs and hospitals to fully and easily satisfy any meaningful use documentation and audit requirements—such functionality must be inherent to certified EHR technology; Urge that audit measures be standardized to be based clearly on the certification requirements, and not subject to auditor variation.

    * To help mitigate disruption from discontinuity in the EHR vendor space due to vendor business failures, vendor consolidation, decisions not to seek certification or performance problems, consider protection or accommodation for hospitals and health professionals that must undertake such EHR product transitions at the same time that they are expected to progress from one stage of meaningful use to another.

    Regarding clinical quality measures (CQM), CHIME noted that over the past several years, CMS, ONC and other agencies inside HHS have demonstrated an increasing ability to convene public and private sector stakeholders to harmonize disparate health IT system requirements, technical standards and disseminate best practices.

    “Meaningful Use is, perhaps, the best example of such policy approaches,” the organization said. “However, CHIME believes that such harmonization with regards to CQMs is overdue – and we believe that time is of the essence.”

    In several of the group’s responses to CQM questions, CHIME urged regulators to keep a handful of fundamental tenets in mind: future measure sets should always tie back to care delivery quality and clinical efficacy; they should be expansive enough to allow clinical flexibility based on population characteristics; and regulators across federal, state, local and private sector reporting organizations should convene to understand what collection and reporting requirements will allow for optimal care quality improvement.

    “Even minute changes to specifications can present tremendous workflow and monetary burdens on providers,” said Liz Johnson, Vice President of Applied Clinical Informatics at Tenet Healthcare in Dallas. “A sensible approach to future measure set development allows for evolution in technology in a way that minimizes such burdens on providers. We need a concerted effort in the near-term that improves data collection, abstraction and reporting on current generation CQMs. This effort should include an absolute focus on harmonizing the current data specifications for similar measures.”

    The full text of CHIME’s response to the proposed measures for Stage 3 can be found at chimecentral.org/wp-content/uploads/2017/06/CHIME_Stage_3_RFC_Response.pdf.

    About CHIME
    The College of Healthcare Information Management Executives (CHIME) is an executive organization dedicated to serving chief information officers and other senior healthcare IT leaders. With more than 1,450 CIO members and over 85 healthcare IT vendors and professional services firms, CHIME provides a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate; exchange best practices; address professional development needs; and advocate the effective use of information management to improve the health and healthcare in the communities they serve. For more information, please visit www.chimecentral.org.

    Contact
    Stephanie Fraser
    Director of Communications
    734.665.0000
    [email protected]

    Updated: 1/14/2013 3:29:42 PM

    Posted 1.14.2013