Health Information Management

OIG report targets EHR copy-paste functionality

HIM-HIPAA Insider, December 23, 2013

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by Jaclyn Fitzgerald, Associate Editor

Please note: This will be the last issue of HIM-HIPAA Insider for 2013. All of us at HCPro wish you a safe and happy new year.

Hospitals that use the copy-paste feature in their EHR could be putting themselves at risk of fraud, according to an Office of the Inspector General (OIG) report. The report is based on data from an online OIG questionnaire of 864 hospitals receiving Medicare EHR Incentive Program payments as of March 2012. The OIG also gathered data from onsite hospital interviews and surveys completed by EHR vendors.

Approximately 24% of hospitals surveyed have implemented copy-paste policies for their EHR system. The copy-paste feature can make data entry more efficient but can also promote the duplication or creation of fraudulent claims, the report stated. Less than half (44%) of hospitals surveyed maintain audit logs that track the method used to enter data in the EHR (e.g., copy-paste, direct text entry, speech recognition). More than half (51%) of respondents said their organization does not have the ability to restrict or disable the copy-paste feature on its EHR system.

The OIG recommends that CMS:
  • Provide organizations with guidance on the proper use of this feature
  • Work with the Office of the National Coordinator (ONC) to develop a plan to address EHR fraud vulnerabilities
Although most of the hospitals surveyed comply with RTI International recommended audit functions, most are not using this functionality fully, according to the OIG report. ONC contracted with RTI International in 2006 to:
  • Develop data protection recommendations
  • Increase the validity, accuracy, and integrity of data
  • Strengthen EHR fraud protection
The OIG also recommends that audit logs should be operational at organizations using EHR technology. CMS and ONC agreed with the OIG recommendations, according to the report.



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