In January, Citizens Memorial Hospital in Bolivar, Mo., became the first rural hospital to achieve Stage 7 on the HIMSS Analytics EMR Adoption Model, and one of only 39 facilities nationwide to reach the top of the scale. Yet, CIO Denni McColm is concerned that affiliated physicians may struggle to meet some of the quality-reporting requirements in the proposed rules for "meaningful use" of health IT.

"The quality-reporting piece is really not getting as much press as I think it should," said McColm, who sat down with FierceHealthIT at a Meditech user's group meeting in Wheeling, Ill., last week.

McColm wonders if providers will be penalized on quality measures if, for example, a doctor doesn't give a specified antibiotic because of a patient allergy. Today's EMRs often require manual chart abstraction to account for such exceptions, and automation is "years away," McColm said.

McColm notes that her team had to build 104 custom fields for reporting on 62 measures for the Medicare Physician Quality Reporting Initiative to account for exclusions, comorbidities and other factors. "It was so overwhelming that [physicians] didn't use the fields, so they failed the quality measures," McColm says.

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