Hennepin County Medical Center in Minneapolis had planned to attest to meaningful use of electronic health records in April 2011. But in testimony given to the HIT Standards Committee on Jan. 11, the hospital notes challenges in being ready to attest that should give any hospital pause.

Running reports for inpatient meaningful use objectives and quality measures "has become an onerous, difficult and time consuming process," testified Joanne Sunquist, CIO. "This is in spite of the fact that we are working closely with our certified vendor who has provided certified reports. It is our understanding that only one Epic customer has been able to successfully run all of the Eligible Hospital MU reports."

Epic did not immediately respond to a request for comment.

Several organizations expecting to seek early attestation when it becomes available in April testified on their experiences getting ready for attestation. Because of its reporting challenges, which Sunquist called the largest challenge to seeking attestation, Hennepin County Medical Center now expects to attest later in the year.

Reporting meaningful use measures and objectives is difficult for two primary reasons, Sunquist testified.

"While our vendor has attempted to define primary and alternative workflows and structured data elements required to support reporting on each objective and quality measure, organizations may or may not have implemented the system using these exact workflows. Therefore, the reports provided by the vendor will not produce accurate results unless we change our workflow and/or documentation requirements. Testing and validating the reports is an iterative process with changes to workflow and ongoing feedback to providers. This effort multiplied by the number of reports is quite sizeable."

The second reason centers on government specifications for meaningful use quality measures, Sunquist noted.

"We have thoroughly reviewed the quality measure specifications provided on the CMS Web site. However, the specifications are so specific, the development and records created for MU quality measures are unique and the same records used for the measure in other programs (such as the PQRI) are not uniformly shared for MU. Our organization might already be reporting on a measure or similar measure for other programs, but we must redo the quality measure record build for MU reporting. In many cases, we will be able to share decision support and documentation tools and use the same workflows for capturing the quality measure data, but the measure results are calculated and reported using unique quality measure records and logic."

In addition to difficulty in running required reports and changing workflows, Hennepin County Medical Center also had to upgrade its reporting database and change database support practices to meet the new reporting requirements. Sunquist in her testimony commended Epic for a range of initiatives to aid clients in achieving meaningful use.

--Joseph Goedert


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