The complexities of clinical quality measures in the 2014 Edition of the electronic health records meaningful use program may outweigh potential benefits as the measures are beyond the ability of many EHR vendors and providers to comply with.
That’s the view of Dave Delano, project director at Massachusetts eHelath Collaborative and executive director of NEHEN, an electronic data interchange network for New England. He also was a leader of the regional extension center serving New Hampshire to help physicians adopt and meaningfully use EHRs.
For example, the SNOMED CT clinical terminology is not widely adopted among providers and vendors, yet Stage 2 starts in October 2013 for hospitals. In particular, EHRs don’t capture communication codes present in 2014 CQMs, such as a specific code that conveys among physicians the degree of a medical condition, or “exclusion” codes that give a patient’s reason for declining medication or notes a patient doesn’t qualify for the medication, DeLano explains. Nor are most providers yet familiar with using SNOMED for clinical documentation, he adds.
Further, adopting SNOMED codes for clinical documentation is a major task, not so far from the complexity of ICD-10, DeLano contends, but the time needed to focus on SNOMED isn’t available as the industry adopts ICD-10. There are benefits to using SNOMED, but if providers and vendors aren’t ready for it, then they won’t be able to attest for meaningful use, he notes. “Providers think they are good because they are on a certified EHR product, but won’t get the clinical quality measures they want if the codes aren’t properly mapped.”
Asked if the federal government recognizes a gap in SNOMED readiness for Stage 2, Delano says, “I think there is awareness that there will be a shortfall in the reporting of CQMs.” He calls on the government to launch a national awareness campaign on the SNOMED requirements and to provide opportunities for learning the codes and testing and evaluating CQMs prior to reporting.
But the reality is that many providers, even if they are working now to be ready for Stage 2 soon, will wind up reporting CQMs and attesting for meaningful use later than envisioned, Delano says. “I do think people will be coming to this party later than they did in the first round, mainly because the CQM requirements are more onerous.”
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