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

In comments submitted to the Centers for Medicare and Medicaid Services (CMS) recently, the College of Healthcare Information Management Executives (CHIME) voiced concern about hospital readiness to submit accurate and complete quality data by way of EHR systems.

Responding to a request for information 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 chief information officers 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 www.cio-chime.org/advocacy/resources/download/CHIME_Response_to_CMS_IQR_RFI.pdf.

Source: College of Healthcare Information Management Executives