CHIME warns quality reporting via EHR not ready for prime time

Responds to CMS request on hospital, vendor readiness

The College of Healthcare Information Management Executives (CHIME) says hospitals are not ready for quality reporting via EHRs. In its comments to the Centers for Medicare and Medicaid Services, submitted Jan. 28, CHIME warned that existing technology and workflow burdens make accurate and complete quality data reporting through the EHR nearly impossible.

CHIME has 1,400 CIO and IT manager members across the country.

“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,” wrote CHIME President and CEO Richard A. Correll and CHIME Board Chair George T. Hickman, who is executive VP and CIO of Albany Medical Center in Albany, N.Y.

[See also: CHIME pushes for untangling of quality reporting.]

“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," they wrote. “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’s comments are in response 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 commended federal efforts towards reaching a harmonized approach for electronic clinical quality measurement (CQM) and 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. 

[See also: Quality reporting alignment on the way.]

The organization 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.

CHIME also urged policymakers and regulators to be bold in their work to establish a unified approach to electronic quality measurement.

“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,” CHIME executives wrote. “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.”