A new study on providers' efforts to demonstrate meaningful use of electronic health records (EHRs) concludes that they have struggled to implement the provision in several key ways, with clinical summary measurement, the security risk analysis, and reporting patient smoking status among the biggest challenges.

The new study, which was published in American Public Health Association's Medical Care and based on data collected from 55 regional extension centers, marks the first nationwide evaluation of meaningful use challenges.

Why hospitals, doctors aren't happy with the meaningful use delay

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicaid and Medicare incentive payments.

In December, federal officials announced that CMS will delay the start of Stage 3 of the meaningful use program, while the Office of the National Coordinator for Health IT (ONC) has proposed adjustments to its certification process.

Study findings

Researchers found that provider engagement and administrative issues were prevalent issues for all of the provider groups. Other issues included:

• Vendor selection;
• Delays in implementation/installation; and
• Practice workflow adoption.

The report also indicates that providers found that measures focused on drug-drug and drug-allergy interactions were the easiest to meet.

Nearly 70% of hospitals have attested to Stage 1 of meaningful use

However, the study notes that challenges varied by practice setting and stage of the adoption process.

The study's authors—which include former ONC head Farzad Mostashari—wrote, "New challenges emerge as providers progress toward [meaningful use], creating opportunities to preempt large-scale issues with timely interventions."

They added, "These interventions must take into account organizational and cultural dynamics, increasing the need to identify multiple, often setting-specific, solutions. If identified quickly and a timely response is provided, problems may be halted before becoming widespread or impeding progress" (Walsh, Clinical Innovation & Technology, 1/19; Heisey-Grove et al., Medical Care, February 2014).

Resources from the IT Strategy Council

Expert insight: What the Stage 3 delay means: More time in Stage 2 for early adopters

Navigate the clinical quality measures: Webconferences for eligible professionals and eligible hospitals