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2/9/2012
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Are Health CIOs Ready For Pay For Performance?

With Meaningful Use Stage 2 requirements just around the corner, a CSC report says IT managers should prepare with a more robust system that addresses care coordination and patient engagement.

12 EHR Vendors That Stand Out
12 EHR Vendors That Stand Out
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Health IT executives at hospitals and physicians' offices should start working now to implement technology that fosters greater patient engagement, enhances patient care coordination, and advances their organizations' ability to electronically capture data for quality reporting--all three of which providers will need to compete in the upcoming pay-for-performance market. That's the conclusion of a new report published by CSC's Global Institute for Emerging Healthcare Practice.

Moving Ahead with Stage 2 of Meaningful Use relies on information from the Centers for Medicare and Medicaid Services' attestation records, which showed what menu requirements for Meaningful Use Stage 1 have been selected compared with those deferred by the early adopters of electronic health records (EHRs). These menu requirements included electronically transmitting summary records during transitions in care and providing patients with access to their electronic records.

By perusing through the CMS records, researchers found that more than 50% of hospitals and practices had deferred implementing technology to support menu requirements related to improving care coordination and patient engagement, two measures necessary to successfully qualify as an Accountable Care Organization.

[ Most of the largest healthcare data security and privacy breaches have involved lost or stolen mobile computing devices. For possible solutions, see 7 Tools To Tighten Healthcare Data Security]

Erica Drazen, the report's author, told InformationWeek Healthcare, "We need patients to be monitoring their own health status, taking prescribed medications, and receiving appropriate tests and preventive care. To do this, patients need access to their information and to educational materials."

Drazen pointed out that such efforts to advance coordination of care will help improve patient outcomes, especially in light of the fact that patients rarely receive all their care at one office. "There are referrals to specialists, involvement of care managers, hospitalizations, and interactions with pharmacies. If all these providers don't have the most up-to-date information, they can't provide efficient or safe care," Drazen observed.

Furthermore, building a health IT infrastructure that captures patient information in the electronic record and reviews quality measures while the patient is receiving care will have an impact on healthcare organizations' budgets.

"The new CMS payment system will reward hospitals that exceed certain quality thresholds and penalize those that don't. Therefore quality outcomes will affect reimbursement as well," Drazen said. To conduct an even deeper examination of the reasons why health delivery organizations were delaying meeting Meaningful Use Stage 1 requirements related to patient engagement, coordinating care, and providing quality reporting measures, CSC collaborated with the College of Healthcare Information Management Executives (CHIME), which conducted a survey of 80 health organizations. Of the respondents, 60% represented individual hospitals, 34% were multi-hospital systems, and 28% represented groups of eligible professionals.

When asked why respondents decided to defer menu requirements, the report states:

"One-half of those who responded cited internal operational readiness or process challenges; another 38% cited vendor product readiness. Only one or two respondents cited costs, or the fact that the capability was not an organizational priority, as a reason for deferring."

The report concludes that Health IT executives need to implement technology now to support three essential areas:

--Providing patients with access to their health information electronically through patient portals or directly from EHR systems

--Electronic capture of physician notes, including diagnosis and treatment, plus rationale for excluding patients from treatment recommendations

--Exchange of patient information during transitions in care.

Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)

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