But growing number of CIOs tell CHIME they are confident their facilities can win federal dollars.
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A survey of hospital CIOs indicates that hospitals are not moving as rapidly as expected to achieve Meaningful Use of electronic health records. But the executives' confidence level that their facilities will reach that goal has risen since a similar poll conducted last March.
In the September survey by the College of Healthcare Information Management Executives (CHIME), 26% of the responding CIOs said their institutions qualified for Meaningful Use. In contrast, 33% of the respondents in the earlier survey said their hospitals either qualified or would qualify by Sept. 30, the end of the first program year for hospitals.
Fewer hospitals than expected are ready for Meaningful Use because of the scope of the program, said Marie Copoulos, consultant, strategic research, for the Advisory Board Company, in an interview with InformationWeek Healthcare.
"As organizations dove in, they realized that each of the Meaningful Use objectives presents its own unique challenges," she noted. "To get to the point where they can report on all of them has taken a lot longer than many organizations had anticipated."
According to the latest survey, 13% of the respondents' hospitals had received government incentive payments by Sept. 30. Four percent of the facilities received the incentives through Medicare, and 9 percent, through Medicaid.
More hospitals received funding through Medicaid than through Medicare because it was easier for them to qualify for the Medicaid incentives. Under the government incentive program, applicants to state Medicaid programs do not have to attest to Meaningful Use in the first year. "You're just attesting to the fact that you've adopted or implemented certified EHR technology," Copoulos observed.
The number of hospitals said to be qualified for Meaningful Use was more than twice as high as the number that had actually received funding. Some facilities have attested and are awaiting payments. Others may attest within the 60 days after Sept. 30, as federal regulations allow. Another group of hospitals have chosen not to attest until 2012 for strategic and timing reasons.
The main reason for providers to delay is the uncertainty over the stage 2 criteria for Meaningful Use. Hospitals that wait until next year to attest will get the same amount of money but will waste fewer resources if they know what to expect in stage 2, which is now scheduled to begin on Oct. 1, 2012.
The Health IT Advisory Committee has recommended pushing the date for stage 2 back a year, but the Centers for Medicare and Medicaid Services (CMS) have not yet adopted that advice. Consequently, Copoulos said, some organizations that have collected their data for Meaningful Use are waiting out the 60-day period to see whether CMS rules on the stage 2 start date before they pull the trigger. If they move now and stage 2 isn't postponed, she noted, they'll face a whole new set of criteria right after they complete their year-long reporting period for stage 1 Meaningful Use in September 2012.
Fifty-three percent of the hospitals had registered for the incentive program by Sept. 30. Among the hospitals that had not, 29% had made a strategic decision to defer attestation until 2012. Twenty-one percent of the facilities were still in the process of purchasing and implementing EHRs, and 18% didn't believe they could achieve the Meaningful Use objectives.
The CIOs' overall confidence level, however, was fairly high. Fifty-eight percent of them said their hospitals' current IT strategy and existing applications would enable them to show Meaningful Use. While 66% still had concerns about the stage 1 requirements, that's down from 90% in the March survey.
Stage 2 is a different kettle of fish. A quarter of the respondents believed their hospitals could meet the stage 2 criteria, but only if the starting date for that phase was postponed to 2013. Thirty-two percent said their facilities could pass the Stage 2 test, with or without a delay, and 35% refrained from making a prediction.
CHIME's report is based on responses from 198 members, representing 656 hospitals. Forty percent of the CIOs work for community hospitals; 35% for multi-hospital systems; 13% for academic medical centers; and 13% for other types of healthcare organizations.