Sloppy EHR Data Signals Need for Standards

Joe Cantlupe, for HealthLeaders Media , February 21, 2013

While the government is starting to think about Stage 3, it hasn't yet begun Stage 2 of Meaningful Use, which starts next year. And although Stage 3 will not go into effect until 2016, the government has already released preliminary recommendations for its requirements.  The HITECH portion of the American Recovery and Reinvestment Act (ARRA) of 2009 specifically mandates that incentives should be given to Medicare and Medicaid providers not for EHR adoption, but for "meaningful use" of EHRs.

In July of 2010 and August 2012, HHS released that program's final rule defining Stage 1 and Stage 2 Meaningful Use.  The government states it is "strongly signaling" that that the bar for what constitutes Meaningful Use would be raised in subsequent stages in order to improve advanced care processes and health outcomes.

While EHR use is increasing dramatically, there are many flaws that must be overcome, especially, day-to-day sloppiness in use of records.  Doctors and other providers are "cutting and pasting" information haphazardly to improve EHR efficiency, but their quick actions are likely to be detrimental to overall recordkeeping and patient care in the long run.

In addition, physicians are using dictation tools that are eliminating the traditional "editing" process of their work, which results in errors, Dougherty says.

Dougherty wasn't alone in her concerns about the EHRs among those who testified before the HIT committee. "All too often a patient's medical information is inconsistently stored—many times in multiple locations, within disparate systems that are not interoperable," Rosemary Kennedy, PhD, MBA, RN, FAAN, VP for health information technology, the National Quality Forum, told the committee.

1 | 2 | 3 | 4 | 5

Comments are moderated. Please be patient.

3 comments on "Sloppy EHR Data Signals Need for Standards"

Reed D. Gelzer, MD, MPH (2/25/2013 at 3:51 PM)
Thank you for the summary article. It is odd that Ms. Dougherty apparently did not mention that extensive EHR System Standards already exist, as well as wide ranging Best Practices in Records Management. Ms. Dougherty was Chair or co-Chair of the Records Management and Evidentiary Support Profile Standard (RMES) Workgroup from its inception in 2004 thru 2011 and presided over RMES's publication as a Normative Standard in 2010, addressing most, if not all, of the gaps she correctly highlights in her comments. The problem, therefore, is not a lack of Standards, it is a lack of use of Standards by vendors, policymakers, and by clinical provider organizations. This is only one element of the current EHR System landscape that demonstrates how, to a great extent, the lack of data quality and information integrity support functions in EHRs has nothing to do with lack of systems capability or knowledge of what constitutes "fitness" in Records Management Systems. With this in mind, please consider a follow-on article to provide your readers with information correcting the impression given by your article that Standards pertinent to data quality and information integrity do not already exist, so that they may better understand the a number of important practical facts: 1. Standards and supporting due diligence tools exist to assure purchase, implementation, and use of EHRs supporting data quality and information integrity, as well as Billing Compliance and, 2. the damage being wrought by Federal subsidies for implementing systems that are not required to meet even the most basic fundamental requirements for a trustworthy electronic patient record, including data quality and information integrity. This would be a substantial and useful public service, as well as a proper credit to the HL7 Standards that Ms. Doughterty helped create, among the many hundreds of other HL7 Standards contributors. Reed D. Gelzer, MD, MPH Currently co-Chair of the HL7 Record Management and Evidentiary Support Workgroup.

Gus Geraci, MD (2/21/2013 at 4:07 PM)
Standards for use and storage would be lovely, for interoperability and many other reasons. The trick is to maintain or improve workflow and usability, many of which have been degraded by MU already. Beware the quest for improvement which degrades with many unintended consequences.

Robert Modugno MD MBA FACOG (2/21/2013 at 2:14 PM)
In their haste to bring EHRs to market both new and old school physicians are having teething problems. Most of their time is spent on data entry rather than on patient care. So far, most docs I know are uncomfortable with EHRs finding them cumbersome and time consuming and therefore they decrease productivity.Different systems don't talk to each other, thus quality medical care is compromised, tests are repeated, etc. The only "winners" are the insurance companies, the govt and the EHR companies. They are still not ready for prime-time IMHO. The doctors will end up taking "the blame" and the extra litigation. Robert Modugno MD MBA FACOG Marietta GA ( Recovering EHR user - three systems so far...)




FREE e-Newsletters Join the Council Subscribe to HL magazine


100 Winners Circle Suite 300
Brentwood, TN 37027


About | Advertise | Terms of Use | Privacy Policy | Reprints/Permissions | Contact
© HealthLeaders Media 2015 a division of BLR All rights reserved.