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Optimism Wanes for Early EHR Incentive Funding

April 13, 2011
by Jennifer Prestigiacomo
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CHIME survey shows CIOs are positive they will achieve MU Stage 1, just not as early as expected

One-third of surveyed members of the College of Healthcare Information Management Executives (CHIME), based in Ann Arbor, Mich., expect to qualify for stimulus funding under the Health Information Technology for Economic and Clinical Health (HITECH) Act in the first year of the program, according to a March 2011 survey.

Results from the survey of 200 CHIME members illustrate a continued decline in optimism among CHIME members aiming to qualify for funding within the first six months of the federal program. Only 7.5 percent of respondents say they expected to qualify for funding by April 1, 2011, compared with 15 percent of respondents to the same question in November and 28 percent of CIOs who responded to the first CHIME survey in August 2010

Additionally, nearly all of the CIOs responding to survey expect to achieve meaningful use Stage 1, while more than 90 percent believe their organizations will qualify for stimulus funding in federal fiscal years 2011 to 2013, which has been fairly consistent with CHIME’s previous two surveys.

“Various sources at CMS [Centers for Medicare & Medicaid Services ]and ONC [Office of the National Coordinator] say that they are very aware that this is a problem that there won’t be enough time between Stage 1 rules being released and when early adopters will attest this year,” says Pamela McNutt, Senior Vice President and CIO of Dallas-based Methodist Health System and Chair of CHIME’s Policy Steering Committee, “and that there is not enough time for folks like that to be able to be ready to do Stage 2. And they are thinking of remediation to that issue”

Top Meaningful Use Concerns
The majority of respondents – about 85 percent – reported a variety of concerns they need to overcome to achieve the meaningful use of EHRs with capturing and submitting quality data being the chief concern (22 percent). That compares to 18 percent who cited quality data as their top concern last November.

“Like anything else the devil’s in the details, and you’ll see that in these top concerns,” says McNutt. “The quality measures are now becoming the sticky wicket for everyone. There are many quality measures that have to be reported by hospitals and these measures have to be created directly from your electronic health record versus having them abstracted and being entered into the CMS website.”

In the November survey, computerized physician order entry was the main concern, cited by 29 percent of CIO respondents, compared to 26 percent of respondents citing that concern in the most recent survey. McNutt adds that in the last survey health information exchange (HIE) was a larger concern for CIOs, with 8 percent of respondents citing it as a top concern. However, in this survey only 3.5 respondents mentioned it. McNutt says this is most likely attributable to CIOs realizing their organizations just have to perform a test, rather than fully participate in an HIE.

Other CHIME survey findings include:
• Nearly 90 percent of respondents still have concerns related to meeting meaningful use requirements.
• Nearly 75 percent of responding CIOs say they are concerned about legislative proposals to repeal incentive funding, including the EHR Medicare and Medicaid Incentive Program.
• Some 55 percent of CIO respondents say they still have lingering questions about the program, nearly six months after the October 1, 2010, start of the stimulus funding program.