HHS, CMS and the ONC have developed electronic health record incentive programs that have successfully promoted the adoption and use of EHRs, but the departments have not taken sufficient steps to ensure this use and adoption leads to improved care delivery, according to a report from the U.S. Government Accountability Office.
The EHR incentive programs have effectively prompted hospitals and eligible providers to adopt EHRs. Participation in the programs increased from 45 percent of eligible hospitals and 21 percent of eligible professionals in 2011 to 64 percent of eligible hospitals and 48 percent of eligible professionals in 2012.
Additionally, providers' attestation reporting reveals they often used their EHR more often than required. For example, Medicare hospitals participating in the meaningful use program used their EHRs' computerized physician order entry feature more than 84 percent of the time, well above the 30 percent needed to meet stage 1 criteria.
However, many of these providers may struggle in reaching the next stages of the EHR incentive programs. Less than 15 percent of all providers attesting to meaningful use stage 1 reported on an optional measure regarding the ability to electronically exchange a summary of care document, a requirement to attest to meaningful use stage 2 this year. The more challenging requirements of the next stages of the program may cause providers to not participate, according to the report.
If providers do not continue to move through the stages of the incentive program, they may not reach a stage where the EHR data is being used to improve patient care. Additionally, technical differences between EHRs that result in clinical quality measures being reported differently may make it difficult to HHS to reliably use the CQMs collected to gauge and guide quality improvement.
The GAO recommends HHS develop a comprehensive strategy that would better help the department monitor not only providers' use of EHRs but how that use is helping providers achieve clinical goals.
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