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In Meaningful Use Reports, Quality Matters

 |  By jcantlupe@healthleadersmedia.com  
   January 20, 2011

The enrollment for meaningful use initiatives has begun, and for physicians that means a slew of requirements that must be met to gain the financial rewards attached.  You are forewarned: don't forget about quality.

Before anyone starts counting their dollars, or wondering what went wrong, researchers Jane B. Metzger and Jared M. Rhoads for CSC, a technology and healthcare company, did some investigating. They spent time "deconstructing" the core measures to meet the meaningful use requirements, especially in terms of "quality" reporting data.

They looked at the necessary information that has to be documented by large medical groups, in particular. Metzger, principal for emerging practices for CSC, based in Falls Church, VA, says that in looking at many levels of meaningful use requirements, they found "hidden functional requirements. "

Hidden? "We call these hidden because they aren't immediately apparent from viewing the list of Stage 1 requirements for eligible professionals," Metzger says. "Stage 1 is largely focused on data capture."

As a result, physicians in large groups should include a wide scope of quality issues in documenting their meaningful use initiatives, Metzger says.

 "A minimalist approach to documenting this information just to meet the meaningful use threshold will not provide sufficient information for quality reporting," says Metzger and Rhoades, a senior analyst for CSC, outline their concerns in a white paper Physician Quality Reporting - The Hidden Requirements of Meaningful Use." In particular, they refer to Stage 1, the requirements for 2011 and 2012, in which "health systems and medical groups need to perform a detailed analysis" of data for quality measure reporting.

The quality provisions within meaningful use data gathering may be complex, but that is to be expected, Metzger says. "Given the orientation of the program as an investment in improving health care, the inclusion of quality reporting in meaningful use is not surprising," they write. "In a health system or medial group, a careful analysis of quality reporting must precede final decisions about how to approach Stage 1 meaningful use for EPs (eligible professionals)."

Metzger says that while she is not predicting how physician practices may be impacted by the meaningful use quality requirements, she notes there is enough complexity in the requirements that should make physicians be concerned and take notice.

In December, the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services released documents shedding light on what physicians and hospitals must do to qualify for EHR incentive payments under the HIECH Act. To quality for incentives, physicians and hospitals must be using "certified EHR technology" in a "meaningful manner." Enrolment for the meaningful use incentives began January 3, 2011.

There is confidence among healthleaders that they will achieve meaningful use within the government's push for electronic health systems by 2016. In a recent HealthLeaders Media Intelligence Report, E-Health Systems, Opportunities and Obstacles, 90% of healthcare leaders say they'll achieve meaningful use from the governmental push for electronic health systems by 2016.

In the meantime, 60% of physician leaders say they are satisfied with the overall functionality of their systems. Of the respondents, 46% cited lack of financing or resources as the greatest challenge of implementing e-health systems, and about a quarter are still struggling to overcome physician resistance to electronic health systems. 

On its face, the medical record information required for the set of measures in meaningful use may seem simplistic, Metzger says. But it is much more complicated, she says, to include determinations, for instance, "if the recommended care was given or desired health outcome achieved."

"One of the points of our (white paper) is that any EP or medical group working to meet Stage 1 requirements needs to look at the specifics as they pick the measures they will use to meet the quality reporting requirement," she says.

For physicians, the bottom line is this: "Health systems and medical groups need to gain a detailed understanding" of what is required, especially for quality measures, Metzger says.

Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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