The College of Healthcare Information Management Executives is raising a number of concerns about regulations released on Dec. 30 that cover the meaningful use of electronic health records.

The Ann Arbor, Mich.-based association supports the phased approach under which first-year meaningful use criteria will apply to hospitals whenever they are eligible to receive Medicare incentives. "However, the current schedule places pressure on hospitals that delay in implementing electronic health records, because by 2015, all hospitals and eligible providers would need to meet Stage 3 criteria to avoid payment penalties," according to a CHIME statement.

Providers need adequate time to understand the impact of new clinical systems and implement them, says David Muntz, senior vice president and CIO at Baylor Health Care System in Dallas. "My primary concern is the time and effort required to achieve successful organizational change management."

Other concerns of CHIME include:

* As a whole, proposed reporting requirements will be burdensome as many measures will require gathering information that spans electronic and paper-based systems;
* Hospitals will need to develop substantial new reporting capabilities as only nine of 35 proposed quality measures currently are used in the Medicare pay-for-reporting program;
* The regulations indicate that physician practices that qualify for stimulus funding no longer will be eligible for the 2% bonus under Medicare's Physician Quality Reporting Initiative; and
* Hospital-based physicians are not eligible under the proposals to receive stimulus payments. "That creates a disincentive for healthcare systems and teaching programs from investing in ambulatory records systems for these physician groups," according to CHIME.

The organization's initial analysis is available at

--Joseph Goedert

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