Hospital group comments on challenges to quality reporting

The Federation of American Hospitals is urging the Centers for Medicare & Medicaid Services (CMS) to avoid duplicative quality reporting programs as the agency works to determine how best to use EHRs to support the Hospital Inpatient Quality Reporting Program.

In a comment letter, the federation calls on CMS to fully integrate the migration of electronic reporting across all relevant programs. “CMS also must recognize that hospitals will be required to continue to report chart abstracted data to other state and national entities such as the Joint Commission,” according to the letter. “Until all of those entities are in total alignment with the CMS requirements for electronic reporting of quality measures, the burden of chart abstraction will remain for many hospitals.”

Quality reporting through EHRs has potential to reduce burden, but several technical challenges stand in the way. The federation urges that electronic measures work as intended before being implemented. “The eMeasures currently in use in the Meaningful Use program are largely re-tooled, chart-abstracted measures that have not been tested and were not developed with the capabilities of an EHR in mind,” the organization asserts. “Moving forward, we recommend that all eMeasures undergo field-testing with an adequate number of hospitals and EHR vendors to ensure the accuracy of data capture requirements and the validity of the data generated, as well as to identify and address gaps in the eMeasures specifications.”

Of particular concern to the federation is that the request for information CMS issued on hospital and vendor readiness for electronic reporting may be overly optimistic of the readiness. “The Meaningful Use program largely has been a testbed for electronic quality reporting. We believe this is appropriate, given that the Meaningful Use program was intended to build functional capacity using EHRs. However, the request for information is suggesting EHR reporting for data that will be used in public reporting and payment programs. This requires a much more robust infrastructure and much higher levels of scrutiny regarding data validity, quality and completeness.”

Read the federation’s comment letter in its entirety.

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