Plenty of work remains to be done before hospitals are comfortable submitting electronic clinical quality measures as a part of the Hospital Inpatient Quality Reporting Program, according to a recent Joint Commission survey.
The survey, conducted in collaboration with the American Hospital Association (AHA) and Federation of American Hospitals (FAH), shows that 37 percent of hospitals have much more work to do prior to the February 2017 eCQM deadline, and 41 percent have least some preparation in the months ahead.
Only 18 percent are in good shape and continually working toward readiness for eCQM submission, and less than two percent are ready to submit tomorrow.
As a result, several hospitals have alternative plans for meeting the eCQM deadline. While 86 percent of hospitals indeed plan on submitting by the February 2017 deadline, some stated that they were going to request an extraordinary circumstances waiver, and other said they were not going to submit eCQMs at all and risk their ability to earn incentive payments in 2018.
The reasons for these struggles lay almost entirely in a hospitals’ EHR. Hospitals listed an inadequate EHR or a newly implemented or optimized EHR as the reasons for requesting an extraordinary circumstances waiver.
For those opting not to submit eCQMs and risk losing a 2018 incentive payment, the ramifications of such actions appear to be unclear. Nearly 33 percent of respondents say they do not know if losing their incentive payment is more costly than implementing and reporting eCQMs.
Just over 29 percent reported that it was financially worth it for their hospitals to opt out of the reporting period and accept the penalty.
For all of these struggles, however, the survey showed a modest light at the end of the eCQM tunnel.
Just over 60 percent of respondents maintained that the February 28, 2017 deadline was achievable for them to fully report their eCQMs. Only approximately 20 percent said that deadline was not feasible.
Hospitals’ confidence in the February deadline is likely related to their confidence in their ability to extract the needed data for eCQMs. Sixty-four percent of respondents said they have the skills to implement eCQMs.
Further, a majority of hospitals reported that they would be able to afford the necessary technology to adequately report eCQMs, and that they would get ample support from their EHR vendors.
Fifty-five percent of respondents said they could adopt the needed health IT, and approximately 45 percent said their vendors would provide support. Just under 21 percent said they would not be able to purchase the necessary technology for eCQM reporting.
That all said, hospitals reported mixed reviews of eCQMs, expressing that they may not be an accurate portrayal of quality and that they likely would not use this method to measure quality if it were not mandatory.
Only 18 percent of respondents said eCQMs accurately display a hospital’s quality, while 29 percent were neutral, 26 percent disagreed, and 18 percent strongly disagreed.
Likewise, only 15 percent of respondents would use eCQMs to measure quality if they weren’t required. Thirty percent were neutral, 30 percent disagreed, and 16 percent strongy disagreed.
The Joint Commission, AHA, and FAH administered this survey of nearly 900 hospitals in an effort to understand the difficulties they face in reporting eCQMs in the new quality reporting leg of the Hospital IQR Program.
The program, thanks to the 2016 IPPS rule, now requires hospitals to submit four eCQMs for patients discharged during the third or fourth quarter of 2016 for the 2017 Hospital IQR Program. As many hospitals expressed that these requirements may be very difficult for them, the Joint Commission, AHA, and FAH will be working on educational services to help hospitals report to this program.