ECRI Institute publishes Health Devices guidance article for hospitals

Electronic health records (EHRs) are the future of medical record keeping. The American Recovery and Reinvestment Act (ARRA) includes incentive payments for hospitals that adopt an EHR, but the timetable for implementation is especially tight. To qualify for the full payment, hospitals will need to demonstrate "meaningful use" no later than October 2012.

To help guide institutions as they scramble to receive incentives while maintaining a thoughtful approach to implementation, ECRI Institute® (www.ecri.org) has published a Health Devices© guidance article outlining what hospitals need to be thinking about -- and doing -- right now. ECRI Institute, an independent, nonprofit organization that researches the best approaches to patient care, also emphasizes the need for hospitals to report EHR problems through a centralized Problem Reporting System.

Currently, only about 9% of the nation's hospitals utilize some type of EHR. And the majority of those hospitals have implemented only the most basic system. "That's not enough to be in compliance with the new standards or to warrant any incentive payment," says Jason Launders, MSc, lead author of the article and senior medical physicist at ECRI Institute.

The HITECH Act -- the portion of ARRA containing the EHR provisions -- states that Medicare and Medicaid incentives, which may total almost half of what it costs to implement an EHR system, will be awarded to hospitals that achieve "meaningful use" of the system under an aggressive timeline, starting as early as October 2010. While a precise definition of "meaningful use" has not yet been released, it will require widespread use of the EHR system throughout the organization, with the capability of exchanging data with outside entities, such as a physician's practice. Hospitals that do not implement an EHR within the designated timeline will receive penalties until they are in compliance.

"Our article clarifies what is known about the HITECH Act -- including details on how incentives will work -- to help hospitals make the right decisions about their EHR system," says Launders. "Additionally, we outline 10 key action steps that hospitals should follow to carefully select an EHR system, and do it quickly enough to receive as much incentive money as they can."

Four of ECRI Institute's recommended steps for successful EHR implementation are:

1. Map out the existing workflow and clinical data flow at your organization.
2. Identify the costs of paper information.
3. Prepare existing medical records for transition to electronic records.
4. Address all security and privacy concerns.

"The rapid pace of EHR adoption due to the government's incentives is likely to result in many unexpected problems," says James Keller, Jr., Vice President, Health Technology and Safety, ECRI Institute. "It is imperative for the hospitals to report these problems to qualified reporting institutions to help prevent them from becoming widespread."

ECRI Institute has run a medical technology problem reporting system for over 40 years. In recent years, the system has expanded to include review and analysis of problems related to computer-based medical technologies like radiation therapy systems and EHRs.

Hospitals can report problems with EHRs and other computer-based medical technologies through ECRI Institute's free and voluntary problem reporting network at https://www.ecri.org/PatientSafety/ReportAProblem/Pages/default.aspx.

"The submitted reports are investigated by our healthcare technology experts, who develop guidance to help hospitals prevent similar problems. It's a great way for hospitals to share their experiences and particularly the challenges with adopting new technologies like EHRs," says Keller.  

The Health Devices journal and findings from the Problem Reporting System analyses are provided to members of ECRI Institute's Health Devices System™, Health Devices Gold™, and SELECTplus™ programs.