Feds plan to address e-health record complaints

The agency responsible for administering the federal program for electronic health records (EHRs) said it plans to address the complaints healthcare providers are making about the implementation process.

Additionally, an important deadline for eligible healthcare providers participating in the Medicare EHR Incentive Program is approaching. Medicare eligible professionals must complete attestation for the 2012 program year by Feb. 28.

Attestation is the process of submitting data from EHR system tests to the U.S. Centers for Medicare and Medicaid Services (CMS) to demonstrate meaningful use of EHR systems. The process is required in order to receive reimbursement money.

Elizabeth Holland, CMS' director of Health IT Initiatives Group, said more than 58,000 healthcare providers received federal reimbursement funds for 2011 EHR attestation.

"We're expecting all those people to come back in January and February of this year," Holland said.

But along with payments have come complaints voiced by physicians that the attestation process itself is too cumbersome, Holland said.

"We're mainly hearing from practices where the doctors have given proxy to a person to attest on their behalf. So that person ends up having to attest for 30 or 40 people, and it takes a long time to put in all the data because you have to do it [doctor by doctor]," she said.

In 2014, CMS plans to set up a batch reporting method, so that data for all physicians in a practice can be submitted under one file.

Healthcare providers receive additional monies as they report on meaningful use for each of three phases of EHR implementation. The three phases take affect in 2012, 2014 and 2016.

CMS has published criteria for Phases 1 and 2 of meaningful use of EHRs, and its Health Information Technology (HIT) Committee is in the process of gathering comments from healthcare providers on what criteria for Phase 3 should be.

Physician and healthcare groups have also voiced strong concerns over EHRs that are not interoperable, meaning patient data cannot be shared among hospitals or private physician practices. Other complaints have focused on EHRs counting data inaccurately.

"So for a lot of those we've tried to be much more clear and done some vendor specifications for Stage 2 because we feel strongly that people need to trust the data they're putting into their EHR," Holland said.

Another complaint has been that the separate phases for showing meaningful use of EHRs requires an unreasonable schedule that does not give physicians enough time to become experienced with EHRs before moving onto Phase 3.

Holland said the timetable for Phase 3 is still flexible, although it is expected to take place in 2016.

CMS does not expect its HIT Committee to review user comments and finalize its recommendations for Phase 3 until June.

"We're still determining what the rule-making schedule would be," Holland said. "The payments for EHRs are mandated by law, but the creation of stages we did on our own, so we could decide not to have a Stage 3 if we desired. The stages weren't written into the law."

Lucas Mearian covers storage, disaster recovery and business continuity, financial services infrastructure and health care IT for Computerworld. Follow Lucas on Twitter at @lucasmearian or subscribe to Lucas's RSS feed. His e-mail address is lmearian@computerworld.com.

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