Hospitals want to have a say in the automated quality reporting of electronic health records in order to ensure that they are “feasible, generate valid and reliable results, and have benefits that outweigh the costs,” the American Hospital Association said in a letter to the Agency for Healthcare Research and Quality.
“Experience from the hospital field in implementing Stage 1 of meaningful use calls into question whether e-measures, as currently configured, will deliver on that promise,” the AHA said in the Sept. 18 letter.
The hospital trade group is asking the AHRQ to conduct more field-based research to answer those questions and to include hospitals in that research.
“The current panoply of initiatives is challenging to navigate and creates considerable confusion,” the AHA said. “Therefore, continued outreach to and inclusion of providers and other stakeholders increases the opportunities for engagement by those participating in concurrent initiatives working toward a common goal.”
One problem is that re-tooled electronic specifications for meaningful-use quality measures have not been field tested and include known errors, causing problems for both providers and vendors, according to the letter.
Automated quality-measurement reporting also requires clinical documentation, including the use of coded data fields, that isn’t typically captured electronically—such as information in written or dictated physician notes, according to the letter. Nor is the level of required information aligned with Stage 1 meaningful use standards, the AHA said.
“We must ensure that the transition to greater standardization of health information appropriately balances the burden and benefit of the changes in practice and investments in technology that are required to support standards,” the association said. “If automated quality measurement is to become widely used, it is more important to get a small number of measures right before moving on to more measures or moving too quickly.”

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