| Hospitals may have difficulty meeting requirements of an expanded quality reporting program under Medicare, unless federal activities to facilitate increased use of health information technology "proceed promptly," the Government Accountability Office said in a report to the top lawmakers on the Senate Finance Committee.
GAO in the report said the Department of Health and Human Services and the Centers for Medicare & Medicaid Services must help hospitals overcome limitations of existing IT systems, so providers can more fully participate in an expanded quality reporting program.
GAO said HHS should identify the specific steps that it plans to take to promote the use of health IT for the collection and submission of data for CMS's hospital quality reporting program and inform interested parties about those steps and expected timeframes, including milestones for completing them.
In a response contained in the report, CMS concurred with the recommendations, saying it will continue to participate in relevant HHS studies and workgroups on the issue. The agency said it would inform interested parties regarding progress in health IT implementation for the collection and submission of hospital quality data, including timeframes and milestones.
"In addition, as IT is implemented, CMS anticipates that a formal plan will be developed that includes training for providers in the use of health IT for reporting quality data," said the report, Hospital Quality Data: HHS Should Specify Steps and Time Frame for Using Information Technology to Collect and Submit Data (GAO-07-320).
The report was released May 4 by Finance Committee Chairman Max Baucus (D-Mont.) and committee ranking minority member Chuck Grassley (R-Iowa).
The 2003 Medicare prescription drug law created financial incentives for hospitals to submit quality data to CMS, and those that do avoid a reduction in their full Medicare annual payment update, GAO said.
CMS to Collect More Data.
CMS plans to expand the number of measures and corresponding data elements hospitals must submit to qualify for the voluntary program, the report stated. Providing that information will be increasingly difficult unless hospitals can automate the process using IT, the report said.
GAO examined eight hospitals for the report, finding a complex process in place for reporting the quality data.
"Our case studies showed that existing IT systems can help hospitals gather some quality data but are far from enabling hospitals to automate the abstraction process," the report said.
"The limitations reported by officials in the case study hospitals included having a mix of paper and electronic records, which required staff to check multiple places to get needed information; the prevalence of data recorded as unstructured narrative or text, which made locating the information time-consuming because it was not in the prescribed place in the record; and the inability of some IT systems to access related data stored in another IT system in the same hospital, which required hospital staff to access each IT system separately to obtain related pieces of information."
Access to this information put a strain on the hospitals' clinical staff, but overcoming the limitations of IT systems could ease the demand on their time, GAO said.
CMS said HHS's American Health Information Community March 13 put forth an initial set of recommendations on the issue of collecting and submitting quality information via health IT systems, and further recommendations are due June 5.
In May 4 statements about the report, Baucus and Grassley said CMS must play an important role in helping hospitals use IT to report quality data.
"This study shows how information technology can facilitate the measurement and reporting of health care quality data," Grassley said. "As CMS increases the number of quality measures for hospitals to report, the need will greatly increase for IT systems that can assist hospitals in all steps of the quality data collection and reporting process."
The GAO report is available on the Web at http://www.finance.senate.gov/press/Bpress/2007press/prb050407b.pdf .
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