Short EHR implementation timeline could lead to errors

If there is such a thing as a general consensus about the proposed rules for "meaningful use" of health IT, it's that the current HHS plan is fairly solid, but in need of some tweaking. It's fairly certain there will be some changes before HHS finalizes its definition this spring; CMS officials have said as much. How much change, and what kind, is up in the air, but it appears that the most common criticism of the Dec. 30 proposal is that the timetable is too short--even though CMS said providers would only have to demonstrate meaningful use for 90 consecutive days to earn the full incentive payment for 2011.

Some of that criticism is starting to show up in academic journals. "[The] extremely aggressive timeline in the American Recovery and Reinvestment Act (ARRA) of 2009 stimulus package places enormous pressure on healthcare practitioners and their organizations to rapidly implement EHRs," often forcing them to install technology without taking the time to tailor systems to organizational realities, Memorial Hermann Health System informatics specialist Dean Sittig and University of Utah health IT guru (and CSC consultant) Dr. David Classen write in the Journal of the American Medical Association.

"Such rapid implementations could lead to significant patient safety events," they add.

To prevent errors, Sitting and Classes propose a five-stage plan to monitor and evaluate EHR systems, including annual self-assessment by EHR users. They also would like to see oversight by the Joint Commission or local health departments and the creation of a national board to investigate "adverse events" related to EHRs.

For details on their plan:
- read this CMIO story about their commentary

Related Articles:
Classen: NQF trumps vendors in meaningful use 'tug-of-war'
Glaser: Remember that an EHR is a tool, and not always the right one
Survey: Those with EMRs more likely to report drug errors