May 8, 2007 - Over the past three years, the Government Accountability Office (GAO) has criticized HHS repeatedly for a chronic failure to set benchmarks by which it can measure the success or failure of its own activities.

Last Friday, the GAO took aim at HHS and the CMS and found they have failed to establish ways to gauge their own progress in promoting the use of healthcare information technology so that hospitals can do a better job of measuring and reporting the quality of care they provide to patients.

While noting that HHS has issued numerous contracts to promote healthcare IT, and created the American Health Information Community to advise the department on IT policy, "HHS has identified no detailed plans, milestones or time frames for either its broad effort to encourage IT in healthcare nationwide or its specific objective to promote the use of health IT for quality data collection," according to the latest report from the federal watchdog agency.

The report's title summarizes the GAO's key recommendation, HHS Should Specify Steps and Time Frame for Using Information Technology to Collect and Submit Data.

GAO researchers based their report on interviews with CMS and HHS officials and studying IT use in quality reporting programs at a sample of eight hospitals in various stages of IT system implementation. Of the hospitals studied, only one had an IT system sophisticated enough that an abstractor could entirely rely on electronic health records to develop the quality report for that hospital, according to a table summarizing the processes used by the hospitals. Six other hospitals had to use combinations of paper and electronic records. At one hospital, all records were on paper. But even at the hospitals where IT systems were available, those systems largely were ill-suited to the task of data abstraction required for quality reporting, the GAO reported.

The case studies showed "that existing IT systems can help hospitals gather some quality data, but are far from enabling hospitals to automate the abstraction process."

Senate Finance Committee Chairman Max Baucus (D-Mont.) and Sen. Chuck Grassley (R-Iowa), the ranking minority party member, issued a joint statement about the report, pledging to "continue to work to ensure that federal healthcare programs such as Medicare collect data on the quality of care offered to beneficiaries by providers."

Baucus said the study "highlights the importance of information technology to healthcare. The report shows that IT can vastly enhance the collection and sharing of data on the quality of care available in American hospitals. More data can help us better determine the quality of care that America is getting with its Medicare and Medicaid dollars. I hope that CMS recognizes how important information technology is to the mission of providing care."

Grassley said, "As CMS increases the number of quality measures for hospitals to report, the need will greatly increase for IT systems that can assist hospitals in all steps of the quality data collection and reporting process. CMS plays an important role in the promotion of health IT. It's critical that the agency be able to track its progress in this regard."


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