Hospitals Show Solid Increase in EHR Meaningful-Use Readiness: HIMSS

Health care IT nonprofit HIMSS has shared new data on how a large number of hospitals are ready to satisfy the Obama administration's meaningful-use guidelines on EHRs.

HIMSS Analytics, the research and analytics arm of the Healthcare Information and Management Systems Society, has released a new report showing a 16 percent increase in the likelihood to meet the criteria for Stage 1 meaningful use of electronic health records.

HIMSS is a nonprofit organization focused on guiding the health care industry on how to improve care by using IT systems.

President Obama signed the Health Information Technology for Economic and Clinical Health (HITECH) Act in February 2009 as part of the American Recovery and Reinvestment Act to set aside $27 billion in incentives for satisfying meaningful use of EHRs. The Centers for Medicare & Medicaid Services (CMS) within the Department of Health & Human Services (HHS) is managing the EHR incentive program.

In September 2011, 41 percent of the 778 hospitals surveyed were expected by HIMSS to meet Stage 1 of meaningful use, up from 25 percent in February.

A little more than 53 percent were not likely to meet the meaningful-use criteria, according to HIMSS.

Hospitals in small towns and rural areas have lagged behind in health IT adoption, while cities and academic medical centers were in the lead, according to John Hoyt, executive vice president of HIMSS Analytics.

"By and large, those in large health systems in urban areas typically are ahead," Hoyt told eWEEK.

A lack of funds may be holding back hospitals in smaller cities and rural areas, according to Hoyt.

"You may have all the desire in the world, but if you don't have access to capital to buy clinical systems, that's a challenge and that seems to be the case for the smaller and rural facilities," Hoyt said.

The Stage 1 meaningful-use criteria require that doctors have at least 80 percent of patient records in electronic form. Hospitals must meet 15 core objectives, and eligible medical professionals must meet 14.

Objectives include maintaining an active medication list, performing drug-allergy interaction checks, providing patients with electronic records upon request and protecting EHR data. In addition, doctors must use computerized provider order entry (CPOE) for ordering medication, equipment and tests.

Some hearings at CMS have taken place on Stage 2, and notice for Stage 2 compliance is expected in January 2013, Hoyt said. Stage 3 guidelines are due in 2015.

Of the hospitals interviewed, 10 percent are ready to meet Stage 1 meaningful-use criteria (14 core areas and five required menu items) now.

Meanwhile, 31 percent are close behind, satisfying at least 10 of the process core measures and at least five of the menu items.

"We're seeing a good increase from last winter on a percentage of hospitals who are able to meet the criteria," Hoyt said. "It tells us clearly people are working on it," he added.

HIMSS announced its new report, called the "Summary of Meaningful Use Readiness," on Nov. 1. It's the first in a quarterly series of reports detailing hospitals' progress on meaningful use.

CMS' stages for meaningful-use adoption are based on HIMSS' EMR Adoption Model (EMRAM), according to Hoyt. EMRAM tracks hospitals' adoption of EHRs in eight stages (0 through 7). Stage 0 is before lab, radiology and pharmacy systems are installed, and Stage 1 involves the installation of those three systems. In Stage 7, a hospital or physician's office has installed a complete EHR platform.

Hospitals with a higher EMRAM were more likely to meet meaningful-use criteria, according to HIMSS.

"The higher EMRAM rankings mean they have a higher adoption of clinical technology," Hoyt said.

Hospitals that had completed HIMSS' Stages 6 and 7 were in line to meet CMS' Stage 1 meaningful-use requirements, Hoyt said.

"They're ahead of the game, and they're more likely to earn Stage 1 because they've already been investing for years in clinical information technology," he said.

Hospitals must also conduct a security risk analysis as part of the meaningful-use process, and 45 percent of the facilities surveyed had completed this task.

Six of the 12 Stage 7 (HIMSS) hospitals completed security updates and identified areas in which to improve their risk management.