Eight in 10 hospital CIOs are reportedly concerned or very concerned they will not be able to demonstrate meaningful use of EHRs within the federally established deadline of 2015, according to a report from PricewaterhouseCoopers’ Health Research Institute.

“After the American Recovery and Reinvestment Act (ARRA) allocated billions of dollars to help hospitals and doctors purchase equipment to computerize patient medical records, even the most sophisticated hospitals in the country are struggling to qualify for the payments,” stated the New York City-based PwC. “Meaningless adoption of EHRs could put meaningful use goals at risk.”

Surveying 120 hospital CIOs who are members of the College of Healthcare Information Management Executives (CHIME) during the second quarter, PwC found:

• Only half of the hospitals and health system CIOs surveyed say they will be prepared to meet the first set of meaningful use requirements and apply for incentive bonuses in 2011; and
• CIOs interviewed for the report said they also were concerned about meeting later-stage requirements within the specified time frames, including advancing care processes through decision support and providing and populating patients’ personal health records.

The promise of stimulus funding has accelerated EHR adoption and the collection of massive amounts of electronic health data as hospitals and physicians across the country race to meet eligibility requirements. But the existing infrastructure to support meaningful use of EHRs on a national health information superhighway is insufficient, according to the CIOs interviewed by PwC.

According to the report, many hospitals are behind the curve on the path to meaningful use. The biggest barriers included:

• Lack of clarity and a final ruling hinder meaningful use implementation: CIOs surveyed by PwC are most concerned about reporting requirements. Ninety-four percent of CIOs said they are concerned they can’t meet government requirements about how to report meaningful use, and 92 percent are concerned about remaining lack of clarity in meaningful use criteria.
• Shortage of skilled staff: The government predicts a shortfall of about 50,000 qualified health IT workers over the next five years. According to the report, hospitals are scrambling to hire additional staff, including clinicians with IT expertise and business skills.
• Vendor readiness and fallout from consolidation are unclear: More than one-third of CIOs surveyed said they are concerned or very concerned about vendor readiness overall. In particular, 44 percent of CIOs said they are concerned that the external vendors they rely on in health information exchanges (HIEs) are not prepared for meaningful use implementation.
• Existing infrastructure capabilities are being questioned: Hospital CIOs are concerned about the unknown cost of maintaining back-up plans should networking systems go down and they have to revert to paper records.

One of the keys to successful meaningful use of EHRs is getting buy-in early on from physicians and increasing the involvement of physicians and other clinicians in quality initiatives, the report said. "Health systems that have connected with physicians, patients and health insurers around meaningful use are more likely to be ready to apply in 2011 for incentives." They are three times more likely to incorporate patient input, 87 percent more likely to work with health insurers and 63 percent more likely to assist physicians with regard to meaningful use than are those planning to apply for the first time after 2011, according to PwC.

In addition, 63 percent of respondents stated their organizations are either already working with physicians around meaningful use issues or plan to do so within the next six months.

“Health systems that include patients in the planning for EHRs are more confident about meeting meaningful use requirements,” the report concluded. “Seventy-four percent of CIOs who had involved patients responded that they would be among those applying for stimulus incentives in 2011, compared with 50 percent of all hospitals and health systems surveyed. Yet, fewer than 20 percent of CIOs surveyed said their organizations are incorporating patient input into meaningful use initiatives.”