Health Information Management

News: CMS hears industry concerns related to EHR implementation during listening session

CDI Strategies, May 23, 2013

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CMS got an earful during a listening session regarding electronic health records (EHRs) held Friday, May 3. The session focused on systems and billing, and featured feedback from AHIMA, the American Hospital Association (AHA), the American Medical Association (AMA), among others.

Many industry leaders expressed frustration with the idea that EHRs promulgate fraudulent activities. Sue Bowman, senior director of coding policy and compliance at AHIMA, told participants that EHRs save time and improve the consistency and completeness of medical records, yet also contain risks such as copy/paste, auto-creation of default documentation, and templates with limited options.
 
Steven J. Stack, MD, Chair of the AMA, pointed to government EHR initiatives and incentives under Meaningful Use (as set forth under "Health Information Technology for Economic and Clinical Health [HITECH] Act") as pushing implementation too quickly for the technology to be used effectively.
 
“Attempting to transform the entire health system in such a rapid and proscriptive manner has compelled providers to purchase tools not yet optimized to the end?user’s needs and that often impede, rather than enable, efficient clinical care,” Stack said.
 
AHA Chairman Benjamin Chu, MD, regional president for Southern California of Kaiser Foundation Health Plan and Hospitals, said EHRs told participants that “[a]s we increase use of EHRs, we need to open the black box and know that these tools support compliant coding.”
 
Many industry leaders called on CMS to provide guidance, oversight, and rules for ethical creation and use of EHR systems, and to ensure that those responsible for creating the technological solutions have a sound understanding of the Official Guidelines of Coding and Reporting and other coding conventions.
Specifically, AHIMA called for:
  • A code of ethics for EHR vendors and users to establish shared accountability for compliant practices
  • Guidelines to address acceptable ways to capture information, limitations on certain features, and assessment of appropriate copy/paste practices
  • National guidelines for hospital reporting of emergency and clinic visits
  • Universal training guides for all EHR systems



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