More than 70 percent of CIOs grade the recently released NPRM on a process to certify EHRs with a C or lower, according to the March healthsystemCIO.com’s Advisory Panel March SnapSurvey®. (To view all charts in a larger format, click here. To go directly to a larger version of any individual chart, click on the chart)
The reasons for the poor grade include concerns that the NPRM’s timelines are too truncated, the document lacks clarity, and the two-step process is one step too many.
Still Too Fast
- “Good intent, but the pace and requirements exceed what the industry can deliver on.”
- “It is a decent plan, but timing is still an issue. Further, there must be adequate time for development, testing and rollout in Stages 2 and 3 and permanent certification.”
Still Too Fuzzy
- “Good intent, but still not definitive information to move forward.”
- “No process exists yet. The ‘process’ which has been published so far is simply a qualification for third-parties to become official certifying bodies. None of the documentation has made the certification process any more clear for actual providers using EMRs.”
- “Very comprehensive in concept and clearly a lot of thought went into the process, but the roadmap, even with the new ‘temporary’ provisions, is much less than clear.”
- “I believe we are still waiting to understand where this is headed.”
A Two-Step Dance
- “Why have two steps to this program? Isn’t it enough to only do this once and correctly?”
- “Would prefer a single process instead of one temporary and one permanent.”
Better than Nothing
- “Not a great plan, but it provides the flexibility needed to meet the deadline.”
When asked about the chances that certification/testing entities are operating in time for organizations to qualify for Meaningful Use funds in October, almost 80 percent placed the chances at less than 50/50, with 38 percent saying there was either a poor chance or no chance at all. Most naysayers thought the numbers just didn’t add up.
They Must Be Using the New Math
- “In order to qualify in October, you would have to be running a certified system for 90 days, which would be July 1. The final rules on certification will not be published until June.”
- “It would take a software release from nearly every EMR vendor to ensure that they could meet the certification requirements. These releases couldn’t be installed and tested in time for October usage.”
Asked if their finance department had baked Q4 2010 Meaningful Use dollars into the budget, most— 70 percent — said they did not, while 25 percent said those numbers had been included.
Not a Good Idea
- “Our CFO wants to do this but it will be at his own peril. He is a smart guy, and I hope he does not make this mistake.”
- “No – They did ask, but are realistic that there are too many unknowns to put it in as a budget marker.”
- “We intended to try to qualify for MU in the first reporting period in Q1 FY 2011 (Q4 2010), but felt that it was premature to bake HITECH into our budget planning since we don’t know yet when CMS will actually award hospitals and EPs the incentive funds.”
When asked if HITECH timelines/deadlines should be extended out at least six months, almost 90 percent answered with a resounding yes.
Are You Kidding …
- “Yes, yes, yes, yes, yes, yes … ”
- “Way too much to accomplish in the time allowed.”
- “Even longer than that. It is irresponsible to have such aggressive timetables and to put CPOE in front of Medication Administration.”
- “Not an extension, as they need to be CHANGED.”
- “At least 6 months, probably more.”
- “Until 2017.”
Asked if they had experienced patient safety incidents related to software bugs — a topic taken up recently by the HIT Policy Committee — 80 percent said they did not, with 20 percent acknowledging some problems.
- “Patient safety bugs are worked on and resolved quickly.”
- “Yes but minor. Anytime there is a major outage or module that runs slowly or inappropriately staff scrabbles to work manually, which then can introduce errors.”
- “We have experienced what I consider serious flaws in software that demanded immediate vendor attention and remediation. In those cases the vendors have been very cooperative and supportive as the incentives and risks are aligned.”
- “Absolutely. We do workarounds or seek to stop use of specific functions when alerted. Our two EHR vendors are very different in their approaches of alerting/remediating.”