While the Department of Health and Human Services has established some performance measures for its meaningful use EHR program that are tied to strategic goals, HHS has not established measures that would "help them to track progress toward program outcomes such as health care quality, efficiency, and patient safety," a new Government Accountability Office report finds.

"Although HHS expects that the use of EHRs can help achieve improved outcomes and support other efforts that are also intended to improve care, that result is not yet assured," concluded the GAO report. "The Centers for Medicare and Medicaid Services and Office of the National Coordinator for Health Information Technology may lack critical information necessary to establish program priorities and subsequently make program adjustments based on progress toward outcomes."

In particular, government auditors argued that the lack of a comprehensive strategy "limits HHS's ability to ensure the department can reliably use the clinical quality measures (CQM) collected in certified EHRs for quality measurement activities." Despite efforts by CMS and ONC to address these concerns, reliability issues persist, said GAO.  

For example, the report pointed out that different providers may report CQMs based on and tested to different requirements depending on whether their EHRs have incorporated technical updates. However, without a comprehensive strategy, efforts to address reliability issues and improve quality and efficiency may be limited.

GAO recommended that HHS develop a comprehensive strategy to better ensure the reliability of CQM data collected using EHRs and develop and use outcome-oriented performance measures to monitor progress toward goals. While HHS agreed that data reliability and performance monitoring are important, the department neither agreed nor disagreed with GAO's recommendations.

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