Standards, IT not ready for CMS data collection

Most electronic medical records systems are not yet capable of collecting and reporting data the government hopes to get through its new voluntary reporting program.

"Naturally, we want to ensure that EHRs are capable of collecting and reporting the data needed for offices to comply with voluntary quality reporting programs," said Mark Leavitt, MD, chairman of the Certification Commission for Health Information Technology. "The ability to collect the data is clearly in our criteria this year," he said. "But when it comes to electronically reporting the data, there are many different quality improvement programs in the public and private sector, and no standardized way to deliver the results to them. Certification requires well developed standards, so the reporting part of the equation may not be certifiable until a subsequent year."

That is what doctors across the country are saying to Mark B. McClellan, MD, administrator of the Centers for Medicare and Medicaid Services. McClellan unleashed a storm of complaints when he announced on Oct. 28 that CMS would go ahead with a pilot program that called for physicians to voluntary report data on 36 evidence-based measures.

Participation in the program may be dubbed voluntary, physicians said, but failure to participate would be perceived as physician resistance. The American Medical Association and the Medical Group Management Association wrote to McClellan to ask him to postpone the program because it would create too much of a burden on physicians.

Physicians are also facing a 4.4 percent cut in Medicare reimbursements this year and as much as a total of 26 percent in cuts over seven years. Many do not yet have the technology that would help them collect and report the data.Physicians are not in a position to participate in the CMS program, said AMA Trustee Chairman Duane M. Cady, MD, in a letter to McClellan signed by all 22 AMA trustees."Initial indications from practice administrators are that few, if any, practice management and EHR systems are ready to facilitate participation in this program," the trustees wrote.

Leavitt, too, indicated the technology was not quite ready for prime-time reporting.

"Keep in mind that EHRs must be installed and operating for a considerable period before useful statistical data can accumulate," Leavitt said. "So certifying the ability to collect the data now, and later certifying the transmission of reports from it, makes sense."